 Good morning everyone. I am Dr. Ashwati Sunil from Osmania Medical College, Hyderabad. My topic for the day is a role of MRA in the evaluation of cellar and supracellar lesions. It means to use magnetic resonance imaging as a modality to identify various lesions that arise from cellar tersica and supracellar lesion with histopathological correlation wherever necessary to document the incidence of optic nerve and cavernous sinus involvement. Introduction. The cellar and supracellar lesion is an anatomically complex area where a number of neoclastic, infectious, inflammatory, developmental and vascular pathologies can occur. Magnetic resonance imaging has superseded other imaging techniques as a modality of choice for the evaluation of cellar and supracellar lesions. Methodology. Study design and place of study. A prospective study was carried out in the department of neurodiagnosis and imaging at Osmania General Hospital, Hyderabad. Study subjects. 35 patients age ranging from 5 to 65 years with suspicion of cellar and supracellar lesions were referred from department of neurosurgery Osmania General Hospital, Hyderabad. Duration of study one year. MRA was performed for all patients using GE 1.5 Tesla scanner. Patients were placed in supine position in the MRA table and typical MRA protocols were done. Inclusion criteria. All patients with clinical suspicions of cellar or supracellar lesions. Exclusion criteria. Patients with already treated cellar or supracellar lesions. And patients con with contraindications to MRA. Coming to the cases. Axel and flare image is showing hyper intense lesion, which is showing intense homogenous enhancement post-contrast study. And there is associated widening of the cellar. Deletion on coronal post-contrast D1 weighted image. There is infiltration of bilateral cavernous sinus with complete encasement of bilateral internal carotid artery. With associated no narrowing of internal carotid artery. Deletion is also involving bilateral optic nerves. This is a pituitary macrivedinoma. Axel T2 weighted image showing T2 iso intense lesion with few hyper intense area. T1 weighted image shows multiple hyper intense area within the lesion and shows blooming on GRE. On post-contrast study, heterogeneous enhancement of the lesion is seen. This is a case of pituitary macrivedinoma with apoplexy. T1, T2 and flare hyper intense lesion which is predominantly cystic and occupying the supracellar region and causing compression of the third ventricle. On post-contrast, heterogeneous enhancement is seen. No restricted diffusion is seen on DWI. This is a case of craniofaryngeoma. A T1 iso intense T2 iso to hyper intense lesion seen in the supracellar region with no restricted diffusion. On post-contrast, homogenous enhancement is seen. This is a case in supracellar meningema. T1 hypo intense T2 hyper intense lesion suppressing on flare with restricted diffusion on DWI. This is a case of epidermal cyst. T1 hyper intense lesion in the supracellar region which is heterogeneously hyper intense on T2 showing blooming on GRE and no restricted diffusion. A few T1 hyper intense 4K are seen in the circle spaces in high right frontal parietal region. This is a case of ruptured supracellar epidermal cyst. A T1 T2 iso intense thickening of the pituitary stalk which on post-contrast shows intense enhancement. This is a case of lymphocytic hypophycitis. T2 hyper intense lesion is seen in the supracellar region which is involving the pituitary stalk and left optic nerve. On post-contrast study, remenhancement is seen. Multiple remenhancing lesions are noted in visualized brain parenchyma. This is a case of supracellar tuberculoma. A well-defined pedunculated mass arising from the tuberocytarium which is projecting into the supracellar system. And the lesion is iso intense to gray matter on T1 and T2 weighted imaging with no restricted diffusion. This is a case of hypothalamic hamartoma. Results. Out of the 35 cases evaluated, 41% were pituitary adenoma and 23% were craniofaryngeoma. We also got two meningioma, two epidermoid, two partial mpcellar, one radkake left cyst, one ruptured demoid cyst, one lymphocytic hypophycitis, one hypothalamic hamartoma, one supracellar tuberculoma and one isianurysum. Age distribution, 25% of the cellular supracellar lesions were found in 36 to 45 year age group with pituitary macrodenoma being the most common pathology. A bimodalase distribution was found in craniofaryngeoma, which included 5 to 15 years and 55 to 65 years. And it was commonest in 5 to 15 years age group. Sex distribution. Female predominance was seen constituting 62.8% of cases and pituitary adenoma was the most common lesion in both males and females, followed by craniofaryngeoma. Optic nerve compression was seen in 54% of cases, 42% of the optic nerve compression were due to pituitary adenoma and 32% were due to craniofaryngeoma. Bilateral optic nerve involvement, which is given by grey, predominated, followed by a right sided involvement, which is given by blue, with only one case of left sided nerve compression, which was seen in supracellar tuberculoma. Kevin Asain's invasion was seen in 10 cases, 90% of which were due to pituitary macrodenoma. 45% of pituitary macrodenoma had bilateral involvement, 33% had a right sided involvement and 22% had only left sided involvement. Histopathological diagnosis was available for 28 cases and MRI could accurately diagnose 96.4% cases. One case reported as subapendymoma, third ventricle, turned out to be craniofaryngeoma. Conclusion, pituitary macrodenomas are the most common cellular supracellar lesion. Most commonly affected age group is 35 to 45 years and most commonly affected genderist female. Craniofaryngeoma, most commonly affects 5 to 15 year age group. Optic nerve involvement and Kevin Asain's invasion are common in cellular supracellar lesions, most commonly by pituitary macrodenoma. MRIs accurately diagnose most cellular supracellar lesions. These are my references. Thank you.