Differential diagnosis of intrasellar tumors by computed tomography.

The specificity of the computed tomography (CT) diagnosis of intrasellar adenoma has not been studied. We compared the CT findings in intrasellar meningiomas, craniopharyngiomas, aneurysms, and metastases with those of pituitary adenomas. Calcification was a features of intrasellar meningiomas, aneurysms, and craniopharyngioma,s but not a typical feature of adenomas. Low-density regions representing necrosis or cyst were found in most types of intrasellar tumors. Eccentricity, hyperostosis, and bone destruction were useful signs of aneurysm, meningioma, and metastasis, respectively. Since adenoma cannot always be distinguished from another intrasellar mass, angiography to demonstrate tumor angioarchitecture may be needed to characterize some neoplasms or to confirm an intrasellar aneurysm.