Radiological Evaluation of Sella Turcica Dimensions in Patients with Empty Sella

Yıl 2022, Cilt: 39 Sayı: 3, 706 - 709, 30.08.2022

Rabia Mihriban Kılınç , Neşat Çullu , İbrahim Yeniçeri , Murat Yunus Özdemir

Öz

Introduction: Empty sella (ES) occurs when the subarachnoid space is herniated into the sella turcica (ST). ES may be radiologically determined randomly, and patients with ES are usually asymptomatic. However, approximately 20% of partial ES (PES) cases can be symptomatic. Therefore, it is important to accurately diagnose patients with ES for treatment. We studied whether there is a difference in ST dimensions between patients with ES and healthy individuals using magnetic resonance imaging (MRI), and we compared a group of measurements using computed tomography (CT).
Materials and Methods: In this study, 212 patients with ES and 98 healthy individuals were enrolled and underwent cranial 3T MRI. The study population was divided into 3 groups: the PES, total ES (TES), and control groups. Patients who underwent both cranial MRI and paranasal CT were placed in a separate group. The aperture, height, and length of the ST of all subjects were measured.
Results: MRI and CT showed that the length, height, and aperture diameters of the ST were statistically significantly different between the PES, TES, and control groups (p < 0.05). In receiver operating characteristic analysis, the cut-off values for the length, height, and aperture measurements were 12.05 mm, 8.35 mm, and 9.65 mm, respectively.
Conclusion: The dimensions of the ST expand in patients with ES, and we found a reliable threshold value for this expansion. CT taken for unrelated reasons may be used in the diagnosis of ES by measuring the dimensions of the ST.
Key: Radiological Evaluation, Sella Turcica, Dimensions, Empty Sella

Anahtar Kelimeler

Radiological Evaluation, Sella Turcica, Dimensions, Empty Sella

Kaynakça

• Referans 1 Alkofide EA The shape and size of the sella turcica in skeletal class I, class II, and class III Saudi subjects. Eur J Orthod (2007); 29(5):457–463.
• Referans 2 Al-Nakib L, Najim AA A cephalometric study of sella turcica size and morphology among young Iraqi normal population in comparison to patients with maxillary malposed canine. J Bagh Coll Dent (2011); 23(4):53–58.
• Referans 3 Andredaki M, Koumantanou A, Dorotheou D, Halazonetis DJ A cephalometric morphometric study of the sella turcica. Eur J Orthod (2007); 29(5):449–456.
• Referans 4 Axelsson S, Storhaug K, Kjaer I Post-natal size and morphology of the sella turcica. Longitudinal cephalometric standards for Norwegians between 6 and 21 years of age. Eur J Orthod (2004); 26(6):597–604.
• Referans 5 Bensing S, Rorsman F, Crock P, Sanjeevi C, Ericson K, Kämpe O, Brismar K, Hulting AL No evidence for autoimmunity as a major cause of theempty sella syndrome. Exp Clin Endocrinol Diabetes (2004); 112(05), 231-235.
• Referans 6 Bergland RM, Ray BS, Torack RN Anatomical variations in the pituitary gland and adjacent structures in 225 human autopsy cases. J Neurosurg (1968); 28 (2):93–99.
• Referans 7 Bruneton, J. N., Drouillard, J. P., Sabatier, J. C., Elie, G. P., & Tavernier, J. F. . Normal Variants of the Sella Turcica: Comparison of Plain Radiographs and Tomograms in 200 Cases. Radiology, (1979); 131(1), 99-104.
• Referans 8 Chaitanya B, Pai KM, Chhaparwal Y Evaluation of the effect of age, gender, and skeletal class on the dimensions of sella turcica using lateral cephalogram. Contemp Clin Dent (2018); 9(2):195.
• Rferans 9 Chiloiro S, Giampietro A, Bianchi A, Tartaglione T, Capobianco A, Anile C, De Marinis L Diagnosis of endocrine disease: primary empty sella: a comprehensive review. Eur J Endocrinol (2017); 177(6):275–285.
• Referans 10 Choi WJ, Hwang EH, Lee SR The study of shape and size of normal sella turcica in cephalometric radiographs. Korean J Oral Maxillofac Radiol (2001); 31: 43–49.
• Referans 11 De Marinis L, Bonadonna S, Bianchi A, Maira G, Giustina A Primary empty sella. J Clin Endocrinol Metab (2005); 90 (9) :5471–5477.
• Referans 12 Hodgson SF, Randall RV, Holman CB, MacCarty CS Empty sella syndrome: report of 10 cases. Med Clin North Am (1972); 56 (4) :897–907.
• Referans 13 Jones RM, Faqir A, Millett DT, Moos KF, McHugh S Bridging and dimensions of sella turcica in subjects treated by surgicalorthodontic means or orthodontics only. Angle Orthod (2005); 75 (5):714–718.
• Referans 14 Komatsu M, Kondo T, Yamauchı K, Yokokawa N, Ichıkawa K, Ishıhara M, Aızawa T, Yamada T, Imaı Y, Tanaka K, Tanıguchı K Antipituitary antibodies in patients with the primary emptysella syndrome. J Clin Endocrinol Metab (1988); 67 (4) :633–638.
• Referans 15 Kyung SE, Botelho JV, Horton JC Enlargement of the sella turcica in pseudotumor cerebri. J Neurosurg (2014); 120(2):538–542.
• Referans 16 Maira G, Anile C, Mangiola A Primary empty sella syndrome in a series of 142 patients. J Neurosurg (2005); 103 (5):831–836.
• Referans 17 Mc Lachlan MSF, Williams ED, Doyle FH Applied anatomy of the pituitary gland and fossa: a radiological and histopathological study based on 50 necropsies. Br J Radiol (1968); 41 (490):782–788.
• Referans 18 Meyer‐Marcotty P, Weisschuh N, Dressler P, Hartmann J, Stellzig‐Eisenhauer A Morphology of the sella turcica in Axenfeld-Rieger syndrome with PITX2 mutation. J Oral Pathol Med (2008); 37(8):504–510.
• Referans 19 Osborn AG, Salzman KL, Jhaveri MD, Barkovich AJ Empty sella. In Diagnostic Imaging Brain, Philadelphia: Alirsys Elsevier.(2015); edn 3, ch 292, pp 1056–1059.
• Referans 20 Ranganathan S, Lee SH, Checkver A, Sklar E, Lam BL, Danton GH, Alperin N Magnetic resonance imaging finding of empty sella in obesity related idiopathic intracranial hypertension is associated with enlarged sella turcica. Neuroradiology (2013); 55(8):955–961.
• Referans 21 Saindane AM, Lim PP, Aiken A, Chen Z, Hudgins PA Factors determining the clinical significance of an "empty" sella turcica. AJR Am J Roentgenol (2013); 200(5):1125–1131.
• Referans 22 Sundareswaran S, Nipun CA Bridging the gap: Sella turcica in unilateral cleft lip and palate patients.Cleft Palate Craniofac J (2015); 52(5):597–604.
• Referans 23 Yasa Y, Bayrakdar IS, Ocak A, Duman SB, Dedeoglu N Evaluation of sella turcica shape and dimensions in cleft subjects using cone-beam computed tomography. Med Princ Pract (2017);26(3):280–285.