Pituitary macroadenoma and diaphragma sellae meningioma: differential diagnosis on MRI

Diaphragma sellae meningiomas are unusual tumours often not distinguished f rom pituitary macroadenomas. Preoperative differentiation is essential, bec ause the trans-sphenoidal approach is used for surgical removal of adenomas , while meningiomas are approached via a craniotomy. We reviewed five patie nts in whom a diaphragma sellae meningioma was initially diagnosed as a non secreting pituitary macroadenoma. MRI criteria for differential diagnosis a re discussed, The main findings considered are visibility of the pituitary gland, contrast enhancement, the centre of the lesion and sellar enlargemen t, These criteria, applied to a blind review, allow correct identification of the tumours.