Prognosis of Hormonal Deficits in Empty Sella Syndrome Using Neuroimaging

Area of Science:

• Neuroendocrinology
• Radiology
• Endocrinology

Background:

• Empty sella syndrome is a condition where the sella turcica is partially or completely filled with cerebrospinal fluid.
• Hormonal imbalances can occur in patients with empty sella syndrome due to pressure on the pituitary gland.

Purpose of the Study:

• To evaluate the relationship between anatomical measurements in the sellar area and hormonal imbalances in patients with empty sella.
• To determine if specific sellar measurements can predict pituitary hormone deficiencies.

Main Methods:

• Sixty-one patients diagnosed with empty sella underwent hormonal testing and pituitary magnetic resonance imaging (MRI).
• Anatomical measurements including interclinoid distance, pituitary stalk to diaphragm distance, sella depth, optic chiasm to diaphragm distance, and adenohypophysis height were recorded.
• Patients were categorized into two groups: those with hormonal anomalies and those without.

Main Results:

• 40.9% of patients (25/61) exhibited hormonal abnormalities, most commonly thyroid-stimulating hormone, T3, and T4 deficiencies (48%) and elevated prolactin (28%).
• Patients with hormonal abnormalities showed significantly reduced right and left adenohypophysis heights compared to those without.
• The hormone-positive group demonstrated significantly diminished right and left adenohypophysis thickness.

Conclusions:

• Adenohypophysis height is a significant indicator of hormonal defects in patients with empty sella syndrome.
• The distance between the pituitary stalk and the optic nerve also serves as a reliable predictor of hormone deficiencies.