Background

MRI is the imaging modality of choice in the assessment of the sellar and suprasellar region. Accurate radiological interpretation of the sellar and suprasellar region can be challenging. Normal appearances of the paediatric pituitary can vary by age and a diverse range of pathologies can be encountered including congenital abnormalities and acquired neoplastic and inflammatory pathologies. Diagnostic accuracy can be improved with optimisation of the imaging protocol, appreciation of normal anatomy and recognition of key radiological features and their associated common clinical presentations.

Objective

- Review the normal anatomy of the sellar and suprasellar region and appreciate how normal pituitary gland appearances can vary with age. - Consider imaging protocol optimisation. - Offer a broad differential of sellar / suprasellar pathologies using a case based approach.

Methods

We will present a pictorial overview of a range of congenital and acquired pathologies affecting the paediatric sellar / suprasellar region from our institution.

Results

We will summarise the normal anatomy of the sellar and suprasellar region and development of the paediatric pituitary gland. We discuss optimisation of the pituitary imaging protocol in the paediatric patient with consideration of the clinical presentation. We present the reader with a range of common and less common abnormalities of the sellar and suprasellar region, highlighting key imaging and clinical features and radiological pearls and pitfalls. The reader with be equipped with an approach to recognising and diagnosing sellar and suprasellar region abnormalities in their daily clinical practice.

Conclusions

It is important for radiologists to have an awareness and understanding of the normal appearance, common and uncommon imaging findings of the paediatric sellar and suprasellar region, and their typical clinical presentations. This can allow the radiologist to maximise their diagnostic accuracy in order to help guide appropriate management and optimise outcomes.