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Neuroradiology

E1204. Parasellar Region: Clinical Presentation and Multimodality Imaging of Uncommon Lesions

Ghaffari A1,  Shah J1,  Schmalfuss I.1,2 1. University of Florida, Gainesville, FL; 2. North Florida / South Georgia Veterans Affairs Medical Center, Gainesville, FL

Address correspondence to A. Ghaffari (ghafar@radiology.ufl.edu)

Background Information: The parasellar region makes up a complex anatomic landscape that is home to a wide variety of common and uncommon lesions. Proper diagnosis of a parasellar lesion is often challenging and requires familiarity with the parasellar region anatomy as well as clinical presentation, natural history, and imaging features lesions in this region. This educational exhibit will focus on diagnosis of uncommon lesions of the parasellar region.

Educational Goals/Teaching Points: The anatomy of the parasellar region will be discussed followed by a case-based review of uncommon parasellar lesions. Emphasis will be placed on common clinical presentations and distinguishing imaging features to facilitate the correct diagnosis.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: Anatomy of the parasellar region will be illustrated. Important structures include the hypothalamic pituitary axis, cavernous sinuses and their contents, meninges, and the optic chiasm. Findings on CT, MRI, and angiography as applicable will be discussed, including the following entities: hypothalamic hamartoma, hypothalamic pilocytic astrocytoma, Langerhans cell histiocytosis, lymphocytic hypophysitis, intracranial internal carotid artery aneurysm, intracranial germinoma, neurosarcoidosis, hypothalamic osteolipoma, epidermoid cyst, dermoid cyst, and cavernous sinus thrombophlebitis.

Conclusion: At the end of this presentation, the learner will have increased familiarity of the clinical presentation and imaging features of uncommon lesions affecting the parasellar region, and will be able to make a correct and confident diagnosis to avoid potentially disastrous surgical intervention.