目的：探讨蝶鞍分区及影像（CT、MRI）征象对鞍区良、恶性占位性病变的鉴别诊断价值。方法：回顾性分析151例经手术及病理证实的鞍区占位性病变患者的资料，按鞍内、鞍上、鞍旁及混合区进行分区讨论，并对其影像征象进行统计分析，探讨蝶鞍分区及影像征象对鞍区占位性病变的鉴别诊断价值。结果：①分区价值：151例鞍区占位性病变中，良性（75%，113/151）明显多于恶性（25%，38/151），鞍内、鞍上、鞍旁及混合区各22、25、42、62例；鞍区良、恶性占位总体在各区域分布间差异具有统计学意义（χ2=6.670，P=0.036＜0.05），鞍内、鞍上、鞍旁占位构成比最高的分别为垂体瘤、颅咽管瘤及脑膜瘤；病灶在累及单区及混合区间差异具有显著统计学意义（χ2=10.246，P=0.001＜0.01）；113例良性占位中，病灶累及单区（66%，75/113）明显多于混合区（34%，38/113），38例恶性占位中，病灶累及混合区（63%，24/38）明显多于单区（37%，14/38）。②影像征象：鞍区良、恶性占位性病变在部位、大小、形态、边界、骨质破坏间差异具有统计学意义；在年龄、性别、肿瘤性质、钙化、垂体是否存在、颈内动脉及海绵窦是否受侵犯或包绕间差异不具有统计学意义。结论：蝶鞍区占位性病变的分布及影像征象有一定的特点，对鞍区良、恶性占位性病变的定位、定性具有较高的鉴别诊断价值。

Objective: To investigate the value of division of sella region and imaging features(CT, MRI) in the differential diagnosis of benign and malignant sellar space-occupying lesions. Methods: A retrospective analysis was made of 151 cases of sellar space-occupying lesions confirmed by surgery and pathology. The imaging features of lesions in the intrasellar, suprasellar, parasellar and mixed areas were analyzed statistically. The value of division of sella region and imaging features in the differential diagnosis of the sellar space-occupying lesions was discussed. Results: The partition value: Among 151 cases of sellar lesions, benign lesions(75%, 113/151) were significantly higher than malignant lesions(25%, 38/151), 22, 25, 42 and 62 cases in intrasellar, suprasellar, parasellar and mix regions respectively. There were significant differences in the distribution of benign and malignant lesions in sellar region(χ2=6.670, P=0.036<0.05), the highest proportion of intrasellar, suprasellar and parasellar were pituitary adenoma, craniopharyngioma and meningioma, the difference of lesions involving single and mixed region was statistically significant(χ2=10.246, P=0.001<0.01), lesions involving only a single zone(66%, 75/113) were significantly more than the mixed zone(34%, 38/113) in 113 benign cases, the lesions involving the mixed area(63%, 24/38) were significantly more than those in the single region(37%, 14/38) in 38 cases of malignant lesions. The imaging features: benign and malignant lesions had statistical significance differences in location, size, shape, boundary and bone destruction. There was no significant differences in age, sex, tumor characteristic, calcification, presence of pituitary, internal carotid artery and cavernous sinus invasion or wrapping. Conclusion: The distribution and imaging features of the sellar region space-occupying lesions have certain characteristics, which is of high value in the differential diagnosis of the sellar region space-occupying lesions.