Meningioma (MRI/CT)	

Meningiomas are the second most common tumour in the sellar region. These tumours may arise from dural surfaces such as the diaphragma sellae, tuberculum sellae, or cavernous sinuses. They may project into the suprasellar space and rarely arise within the sella. Meningiomas are usually isointense with grey matter on Tl- and T2- weighted images and enhance intensely following contrast administration. Differentiation from an adenoma with suprasellar extension may be difficult. A dural ‘tail’ sign may be produced by adjacent dural enhancement (Fig. 24.14). Coronal images are very helpful in distinguishing the purely suprasellar location of the meningioma from the intrasellar and suprasellar location of the adenoma.

Fig. 24.14 Meningioma. Contrast-enhanced, T1-weighted coronal MR adjacent ‘dural tail’. Coronal CT image (b) in a different patient also image (a) demonstrating an enhancing suprasellar meningioma with demonstrating an enhancing suprasellar meningioma.