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MRI is the gold standard for diagnosing the empty sella sign. Key features include: [5] CSF signal: The sella turcica is filled with material that follows the signal characteristics of CSF on T1-weighted and T2-weighted images. Flattened pituitary gland: The pituitary gland appears thin and plastered against the sellar floor or walls.
Empty sella syndrome is the condition when the pituitary gland shrinks or becomes flattened, filling the sella turcica with cerebrospinal fluid instead of the normal pituitary. [2] It can be discovered as part of the diagnostic workup of pituitary disorders, or as an incidental finding when imaging the brain.
The pituitary gland or hypophysis is an endocrine gland in vertebrates. In humans , the pituitary gland is located at the base of the brain , protruding off the bottom of the hypothalamus . The human pituitary gland is oval shaped , about 1 cm in diameter, 0.5–1 gram (0.018–0.035 oz) in weight on average, and about the size of a kidney bean .
One cause of pituitary growth associated with the risk of Sheehan's syndrome is the hyperplasia of lactotrophs which produce prolactin, the hormone responsible for milk production. [5] Other hormone-secreting cells of the pituitary undergo rapid growth in pregnant women as well, which contribute to the gland's enlargement. [10]
The pituitary gland consists of two parts, the anterior (front) and posterior (back) pituitary. Both parts release hormones that control numerous other organs. In pituitary apoplexy, the main initial problem is a lack of secretion of adrenocorticotropic hormone (ACTH, corticotropin), which stimulates the secretion of cortisol by the adrenal ...
A CT or MRI of the pituitary may also show the ACTH-secreting tumor if present. However, in 40% of Cushing's disease patients MRI is unable to detect a tumor. [8] In one study of 261 patients with confirmed pituitary Cushing's disease, only 48% of pituitary lesions were identified using MRI prior to surgery.
Hyperpituitarism is a condition due to the primary hypersecretion of pituitary hormones; [3] [medical citation needed] it typically results from a pituitary adenoma.In children with hyperpituitarism, disruption of growth regulation is rare, either because of hormone hypersecretion or because of manifestations caused by local compression of the adenoma.
With pituitary adenomas larger than 1 cm, a baseline pituitary hormonal function test should be done, including measurements of serum levels of TSH, prolactin, IGF-1 (as a test of growth hormone activity), adrenal function (i.e. 24 hour urine cortisol, dexamethasone suppression test), testosterone in men, and estradiol in amenorrheic women. [11]