Sella turcica x-ray is a method of X-ray diagnostics of neuroendocrine pathology, which allows a targeted examination of the pituitary bone bed in the sphenoid bone of the skull: its contours, dimensions, shape, etc. It is of diagnostic importance for the detection of pituitary tumors with hyperprolactinemia and a reduced level of gonadotropins. It is usually performed in 2 projections – frontal and lateral. On sighting craniograms, the anterior-posterior (sagittal), vertical dimensions are measured, the index of the sella turcica is calculated, contours are evaluated, the presence of deformation of the walls, etc.
Indications
Sella turcica x-ray can be prescribed for the following indications:
- trauma to the skull and deformity of the head in part of the face;
- disruptions in the growth of the child (delay or acceleration);
- constant headaches;
- pathology of the thyroid gland;
- increased prolactin content in the blood;
- violation of spermatogenesis in men;
- menstruation disorders in women;
- loss of visual acuity;
- unexplained, sudden aging of the body, loss of strength;
- intracranial hypertension syndrome;
- abnormal structure of the cranium;
- infertility (both men and women).
What show
Sella turcica x-ray can be used to judge its shape, structure and size. The pituitary gland is also visualized on an X-ray and the following signs may indicate its tumor:
- local or complete osteoporosis of the walls of the sella turcica with the preservation of the normal structure of other bone formations;
- local or complete atrophy of the walls of the sella turcica (in the pictures you can see how thin the walls are);
- local or complete thinning of the wedge-shaped processes of the sella turcica;
- uneven contours of the sella turcica from the inside.
Preparation
Immediately before the X-ray, the patient needs to take off metal objects – jewelry, hairpins. If possible, you need to remove the dentures. If the patient has an auditory implant, it is necessary to warn the doctor about this.
Method of conducting
The patient stands up or sits down in front of the X-ray machine so that it is possible to get a picture of the skull in a lateral projection. If necessary, the shooting is performed in a direct projection. In terms of time, radiography takes no more than five minutes.
Interpretation
The description of the image and the conclusion are performed by a specialist radiologist. At the same time, it determines the condition of the wall, as well as the shape and size of the sella turcica. If a tumor is visualized on the image, the doctor describes its size, structure and localization. Radiography can sometimes show such pathology as an “empty sella turcica”. Its signs may be as follows:
- the bottom in the frontal plane is symmetrical;
- vertical increase of the closed-form seat;
- two-contour bottom on the sagittal image.
Externally, the “empty sella turcica” practically does not manifest itself in any way, that is, it does not have pronounced symptoms. Women are more prone to such pathology, and its most important consequence is infertility.
Normal indicators
The criteria for the interpretation of X-ray images are the norms of the size of the bones of the sella turcica:
- vertical size – from 7 to 12 mm;
- sagittal size – from 9 to 15 mm.
In addition to the criteria listed above, there is another one that also needs to be compared with the norm – the ratio of the height of the sella turcica to its length. This index in adults should be greater than 1, and in children – less. The definition of this index makes it possible to understand whether there is a deviation in the structure and structure of the pituitary gland. In the normal condition of the sella turcica, the medical record indicates the absence of pathology.
Contraindications
Why you need to do a sella turcica x-ray, it is clear. However, is such a diagnostic procedure shown to everyone? Let’s figure out the contraindications:
- pregnancy;
- serious condition of the patient;
- oncological diseases of any kind;
- leukemia.
In the presence of such contraindications, the doctor should consider replacing radiography with magnetic resonance imaging of the sella turcica. This research method is based on the use of a magnetic field. A CT scan of the skull may also be prescribed for diagnosis. It allows you to get a three-dimensional image and detects pathological foci of small sizes.
