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REVIEW ARTICLE
Year : 2020  |  Volume : 11  |  Issue : 1  |  Page : 3-16

Imaging of sella: Pituitary adenoma and beyond


1 Department of Radiology, Seth GS Medical College, KEM Hospital, Mumbai, Maharashtra, India
2 Department of Radiology, Nanavati Superspeciality Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Rutwik Ketkar
Department of Radiology, Seth GS Medical College, KEM Hospital, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrcr.jrcr_23_19

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Sella is a small structure in the skull base housing the pituitary gland. Our aim is to show common and not so common lesions in the sellar-suprasellar region and to highlight unique imaging features which can clinch the diagnosis. A study of pituitary should always include the pituitary–hypothalamic axis. Pituitary masses can be divided into various categories, and the focus of this article will be mainly on primary pituitary tumors. Pituitary adenoma is the most common tumor. Based on the size, it is divided into microadenoma (<1 cm) and macroadenoma (≥1 cm). While radiography and computed tomography were used initially for suspected pituitary tumors, magnetic resonance imaging with its multiplanar imaging and an excellent soft-tissue contrast is the investigation of choice. Dynamic imaging is helpful in diagnosing and localizing microadenomas enabling effective surgical management when medical treatment fails. The sellar region is one of the most anatomically complex central nervous system locations. The key to diagnosis lies in understanding the gross and imaging anatomy by dedicated protocols. Structured reporting of pituitary masses ensures a comprehensive analysis of the lesion, based on several imaging characteristics as described in this article, which is finally aimed at dispensing the information required by the treating physician or surgeon. Imaging can now help in predicting surgical outcome, response to medical treatment, and to avoid complications.


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