Imaging of Pituitary and Parasellar Disorders

Robert Fenstermaker, MD, FACS, FAANS; Ajay Abad, MD Neuroimaging p. 1574-1594 October 2016, Vol.22, No.5 doi: 10.1212/CON.0000000000000380
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Purpose of Review: This article reviews sellar and parasellar anatomy and the appearance of normal bone and soft tissue components on both CT and MRI. Pituitary gland structure and function are discussed with respect to hormone secretion, along with clinical syndromes caused by perturbations in hormone levels. Syndromes and specific diseases in the sellar and parasellar regions are discussed along with characteristic clinical features and imaging findings.

Recent Findings: Bone and calcifications are best visualized with CT scans, while soft tissues are better defined using MRI. Some lesions have characteristic enhancement patterns with contrast; the presence of delayed contrast uptake further narrows the differential.

Summary: Lesions that commonly occur in the sellar and parasellar region include benign and malignant tumors, cysts, vascular pathology, inflammatory processes, and abscesses. Knowledge of sellar and parasellar anatomy and attention to the use and interpretation of various imaging modalities can be of great assistance to the clinician when formulating a differential diagnosis for lesions in this region.

Address correspondence to Dr Robert Fenstermaker, Department of Neurosurgery, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, Robert.Fenstermaker@RoswellPark.org.

Relationship Disclosure: Dr Fenstermaker serves on the board of directors of and owns stock or stock options in MimiVax, LLC; receives personal compensation for meeting organization from prIME Oncology; and receives research/grant support from the Roswell Park Alliance Foundation. Dr Abad has provided expert medicolegal testimony on tumor treatment field therapy.

Unlabeled Use of Products/Investigational Use Disclosure: Drs Fenstermaker and Abad report no disclosures.

Copyright © 2016 by the American Academy of Neurology.