Magnetic Resonance Imaging of Suprasellar Tumors and Accuracy of Diagnosis

Abstract

Background: One of the best ways to diagnose tumors involving intrasellar and suprasellar regions is MRI. Mostly, the differential diagnoses are Pituitary adenoma, Craniopharyngioma, and Rathke's cleft cysts. Differentiating them is essential because each has a distinct surgical approach. Therefore, we studied helpful MRI features to differentiate them.

Materials and Methods: We measured the clinical symptoms and functionality of the pituitary gland of 81 patients diagnosed with Pituitary adenoma (n=46), Craniopharyngioma (n=19), and Rathke's cleft cysts (n=16) from March 2010 to March 2019. We also used the MRI images performed by a 1.5 T MRI machine to determine the qualifications of the tumor, such as component characteristics, shape, volume, spatial extension, solid and cystic segment pattern.

Results: The most common component characteristic was solid type in pituitary adenoma (63.0%, n=29), mixed type in Craniopharyngioma (84.2%, n=16), and cystic in Rathke cleft cyst (100.0%, n=17). The most prevalent shape in pituitary adenoma, Craniopharyngioma, and Rathke cleft cyst was the snowman-like appearance (60.9%, n=28), superiorly lobulated (68.4%, n=13), and ovoid (70.6%, n=12), respectively. Small tumors were more frequent in the Rathke cleft cyst (88.2%, n=15), and large tumors were more common in Craniopharyngioma (89.5%, n=17). Compressing the optic chiasm in pituitary adenoma (95.6%, n=44) and compressing the third ventricle in Craniopharyngioma (68.4%, n=13) were significantly different. All Rathke's cleft cysts were surrounded by the lateral wall of the cavernous part of ICA (100.0%, n=17).

Conclusion: We statistically showed that several MRI features are specific for each tumor and suggest a precise diagnosis.