Volume of sella turcica in normals and patients with peripheral endocrinopathies or idiopathic gonadotropin deficiency

Abstract

The volume of sella turcica (VST) was estimated from x-ray films in i) 883 control subjects (507 men and 376 women), ii) 135 adult patients with peripheral endocrine gland insufficiences (71 of the thyroid, 15 of the adrenals and 49 of the gonads) and iii) 41 adult patients with idiopathic gonadotropin deficiency. The mean VST value of men (1356 +/- 22 mm3) was significantly lower (p less than 0.05) than that of women (1428 +/- 25 mm3). This difference resulted from a progressive increase of VST in women after the age of 45 (r = 0.254, p less than 0.001); the mean VST value of women aged less than 45 years (1301 +/- 33 mm3) been similar to that of men (p less than 0.05). VST was significantly (p less than 0.001) increased in peripheral endocrine insufficiences, this increase varying approximately between + 30% and + 55% of the mean volume of normals according to the endocrinopathy. Definitely abnormal sella turcica (VST larger than + 2SD) were observed in a percentage smaller than 27% of the cases in all groups. Furthermore, the increase in VST was significantly related to the severity of the disease in primary hypothyroidism (p less than 0.001) and the duration of the abnormal condition in Addison's disease and primary gonadal failure (p less than 0.001). Finally, VST was found within normal limits in patients with idiopathic gonadotropin deficiency. It is concluded that natural (menopause) or pathological peripheral endocrine insufficiency leads to VST enlargement which exceeds the upper normal limits in less than 27% of the cases.