X-Ray Pituitary Saddle
The pituitary is a crucial pea-sized endocrine gland located at the base of the brain. It is involved in nearly all processes of homeostasis, as well as growth and development. The pituitary sits in a saddle-like compartment in the skull called the sella turcica.
Many pathological processes inside and outside the cranium cause changes to the pituitary fossa or sella turcica. These radiographic changes are valuable diagnostic tools to aid and detect several endocrine diseases. An enlarged or deformed sella turcica may hint towards pituitary pathology. It is located deep into the skull but may be visualized on an X-ray with projections used in skull radiography. Radiography is used for screening purposes and helps identify calcifications and destructive changes in the sella turcica and adjacent regions. Other obscure conditions that may require you to get a Pituitary X-ray done are Intrasellar Aneurysms, Pituitary Apoplexy, and Rathke Cleft Cyst.
If you experience headaches, alteration in mental status, visual deficits, and oculomotor palsies, your doctor may prescribe you a Pituitary X-ray to rule out/treat Pituitary Apoplexy. Changes in and around the sella turcica can reflect numerous intracranial pathologies, not limited to the pituitary gland. Your doctor will perform physical exams and ask for a detailed history before concluding. A lot of the differential diagnosis depends on the findings of the radiograph. Some common radiological findings in the sella turcica and associated pathological conditions/symptoms are:
- Enlarged sella turcica, associated with Empty Sella Syndrome
- pituitary insufficiency
- altered shape and contour associated with pituitary tumors
- erosions in the wall or floor due to aneurysms or chronic intracranial pressure
- Meningioma of sella turcica resulting in thickening of clinoid or tuberculum processes
- thinning bone density
- craniopharyngioma with symptoms: headaches, visual problems, hormonal imbalances, and behavioral changes due to frontal extension.
- fat and calcification in the intrasellar, suprasellar or parasellar region
X-ray is a routine procedure that does not require any special preparation. However, make sure you keep the following points in mind before your appointment:
- If you are pregnant or think you might be, inform your physician and radiologist to discuss the exposure limit for the developing fetus.
- Remove any jewelry or metal objects that might distort the radiographic image.
- Consult the X-ray technician if you wear any on-body devices such as an insulin pump or have metal implants from prior surgeries
- You may be asked to change into the hospital gown for the imaging at the time of the scan
The sella turcica is best visualized on lateral radiographs of the skull. Your X-ray technician will guide you to a comfortable position and step into an adjacent room to monitor the X-ray machine. The technician will adjust positions repeatedly to attain more clearer, exact radiographs. The positions might feel uncomfortable for a patient, but they need not be held for more than a few seconds. Remaining still is crucial, however. The patient will be asked to wait after imaging until they are processed to see if a repeat procedure is required in case of blurred radiographs.
Pituitary gland X rays are used to identify and treat various clinical pathologies. One of the rare ones that an X-ray helps diagnose is a disorder in which an enlarged or malformed sella turcica contains a tiny pituitary gland. The condition is known as Empty Sella Syndrome. The condition usually manifests as asymptomatic, although hormone deficiencies may occur. When an empty sella turcica is seen on a radiograph in the context of primary idiopathic intracranial hypertension, successful treatment is reported to result in the pituitary regaining a normal size. Benign tumors such as Pituitary Adenomas may manifest on the X-ray. Other conditions such as schwannomas, hemangioblastomas, primary sellar melanomas, and cavernous angiomas may clinically mimic pituitary adenomas. Other sellar tumors might appear on the radiographs. Whatever shows up on your radiograph, your doctor will help you walk through the plans and discuss all findings with you.
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