目的探讨临床偶然发现的垂体占位性病变的诊断和处理。方法系统分析１９８９～１９９７年３４例ＣＴ和ＭＲＩ偶然检出的垂体占位性病变的临床资料。结果２９例有头痛等颅内病变临床表现，仅３例表现轻度内分泌检查异常。３４例中微型病灶占２６例（７７５％）。２６例经蝶手术切除病变，其病理诊断为：８例无功能大腺瘤，７例微腺瘤，５例垂体增生，６例Ｒａｔｈｋｅ囊肿。随诊２３例无病变复发。结论重视对慢性头痛患者行ＣＴ和ＭＲＩ检查。对大于１５ｃｍ或１０～１．５ｃｍ随诊期有病变增大证据者主张经蝶手术切除。而１０ｃｍ以下的病变应定期随诊 Objective To explore the diagnosis and treatment of accidentally discovered pituitary space-occupying lesions. Methods The clinical data of 34 cases of accidental pituitary lesions detected by CT and MRI were systematically analyzed from 1989 to 1997. Results There were 29 cases with clinical manifestations of headache and other intracranial lesions, and only 3 cases showed mild endocrine abnormalities. Among the 34 cases, 26 cases (77.5%) were micro-lesions. Twenty-six cases were treated by transsphenoidal surgery. The pathological diagnosis was: 8 cases of non-functioning large adenomas, 7 cases of microadenomas, 5 cases of pituitary hyperplasia, and 6 cases of Rathke cysts. Followed up in 23 cases without disease recurrence. Conclusion The importance of CT and MRI in chronic headache patients was examined. For patients with evidence of lesions larger than 15cm or 10～1.5cm at the time of the follow-up examination, they should undergo transsphenoidal surgery. The lesions below 10cm should be regularly followed up