Background : The sellar region is a relatively complex anatomical area surrounding the pituitary gland and contains crucial neuro–vascular structures. Pituitary lesions although relatively infrequent, have a significant impact on the quality of life. The main aim of this study is to discuss the crucial anatomy and identification of the characteristic features of the important pathological lesions involving the sellar, parasellar and suprasellar regions. This study also emphasizes on the role of advanced imaging modalities like Magnetic Resonance (MR) imaging in evaluation of pituitary–hypothalamic axis lesions. Magnetic resonance imaging has been proven to be the imaging modality of choice in the neuroimaging assessment of most pathology occurring at the skull base.

Materials and Methods: MRI brain of 59 patients with varying clinical symptoms was performed on

1.5–T MR system using a dedicated head coil.

Purpose: To illustrate imaging features of various sellar, parasellar and suprasellar lesions using MRI.

Results: A total of 59 patients in a span of 2 years were compiled and analyzed, comprising of 34 cases of macroadenomas, 10 cases of juxta/parasellar meningiomas and 9 cases of craniopharyngiomas. Majority of patients in this study belonged to the age group 31–40 years. Females predominated in this study constituting 60% of the total study population. Commonest overall sellar/parasellar/suprasellar mass on MRI was pituitary macroadenoma (34%).

Conclusion: MRI is an excellent modality for classifying and evaluating the different sellar, parasellar and suprasellar lesions. Recent advanced MRI tests aids in characterization and narrowing the differential diagnosis, for definitive diagnosis, still histologic tissue evaluation is needed for uncommon and tumors with atypical presentation. Thus by providing complete information, MRI helps in better management and prognosis of these patients