Intraoperative delineation of lesions in the sellar region with metrizamide.

Televised fluoroscopy during surgery has been an important factor in the resurgence and ref inement of the transsphenoidal approach to se llar lesions. It provides continuous control of placement of instruments, and permits further rad io logic evaluation of the extent of the lesion . Intraoperative pneumoencephalography has been used to delineate sellar tumors [1], but the image obtained is often unsatisfactory. We have found intralesion injection of metrizamide to be a better method for radiologic visual ization of pituitary and parapituitary lesions during surgery.