Quantitative Measurement of the Sella Turcica in Pseudotumor Cerebri

Woon Hyung Ghim; Sung Eun Kyung

doi:10.3341/jkos.2014.55.6.887

Journal List > J Korean Ophthalmol Soc > v.55(6) > 1009997

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Ghim and Kyung: Quantitative Measurement of the Sella Turcica in Pseudotumor Cerebri

Original Article

J Korean Ophthalmol Soc 2014;55(6):887-890.

Published online: 30 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.6.887

Quantitative Measurement of the Sella Turcica in Pseudotumor Cerebri

Woon Hyung Ghim, MD, Sung Eun Kyung, MD, PhD

Department of Ophthalmology, Dankook University Medical College, Cheonan, Korea

Address reprint requests to Sung Eun Kyung, MD, PhD, Department of Ophthalmology, Dankook University Hospital, #201 Manghyang-ro, Dongnam-gu, Cheonan 330-715, Korea, Tel: 82-41-550-6497, Fax: 82-41-561-0137, E-mail: kseeye@hanmail.net

Received 26 July 2013 Revised 19 January 2014 Accepted 1 May 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

In this study we evaluated the hypothesis that sella turcica enlarged in size due to increased intracranial hypertension by measuring the sella turcica area using magnetic resonance imaging (MRI) in patients with increased intracranial hypertension and compared to normal controls.

Methods

Brain magnetic resonance (MR) midsagittal images of patients diagnosed with pseudotumor cerebri from 2005 to 2012 at Dankook University Hospital and 10 normal controls who had no overt signs or symptoms of neurological disease and had nor-mal gadolinium-enhanced MR examination of brain were compared. The area of the sella turcica was measured by the dou-ble-blind method using Dicomworks v 1.3.5b (Philippe Puech and Loic Boussel, Freeware, France). Statistical analysis was con-ducted using GraphPad Prism (GraphPad Software, Inc., USA) and Mann-Whitney U-test.

Results

The sella turcica areas of 2 pseudotumor cerebri patients were 93 mm² and 123 mm² and were significantly larger than in the controls (p = 0.03).

Conclusions

Empty sella which commonly occurs in pseudotumor cerebri can be caused by pituitary gland atrophy but, con-versely, can result from the enlargement of the bony sella in response to an abnormal cerebrospinal fluid pressure gradient.

Keywords: Empty sella, Increased intracranial hypertension, Pseudotumor cerebri, Sella turcica

References

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Figure 1.

(A) T1-weighted mid-sagittal image of the sella turcica and pituitary gland from a normal subject. (B) Drawing showing the dimensions that were measured to determine the opening (solid line) and contour (dotted line) of the sella turcica. In this example, the sella area = 93 mm.

Figure 2.

Tl-weighted mid-sagittal image of 17-year-old wom-an patient showed partially empty sella (turcica area: 93 mm²).

Figure 3.

Tl-weighted mid-sagittal image of 28-year-old wom-an patient showed prominent empty sella (turcica area: 123 mm²).

Figure 4.

The size of pseudotumor cerebri patients’ sella turcia was each 123 mm², 93 mm² and the median value was 108 mm². The median value of the control group's sella turcia size was 67.5 mm².

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