title: Factors determining the clinical significance of an "empty" sella turcica.
abstract: OBJECTIVE
  Although often incidental, the "empty" sella turcica can reflect chronically elevated intracranial pressure (ICP). It is particularly common in the setting of idiopathic intracranial hypertension (IIH). This study evaluated which clinical and MRI findings could be used to differentiate patients with chronically elevated ICP from those with incidental empty sella turcica.
  
  
  METHODS
  Forty-five patients with definite IIH and 92 patients with "empty sella" reported on brain MRI were evaluated. Measurements of the sella turcica, diaphragm sella, pituitary gland, infundibulum, and scalp and neck soft tissues were made on MR images. These measurements, age, sex, clinical symptoms, and frequency of previously reported orbital findings of IIH were compared between the IIH and incidental empty sella turcica groups. Measurements on MRI were correlated with patient age in each group.
  
  
  RESULTS
  The IIH and incidental empty sella turcica groups had statistically similar sellar, pituitary, and infundibular measurements. The patients with IIH were significantly younger than the patients with incidental empty sella turcica (mean age, 36.1 vs 54.3 years, respectively; p < 0.05); were more likely to report headache (93.3% vs 32.6%; p < 0.05) and visual complaints (66.2% vs 28.3%; p < 0.05); showed greater mean scalp thickness (9.0 vs 6.4 mm; p < 0.05) and neck soft-tissue thickness (19.5 vs 13.8 mm; p < 0.05); and were more likely to have an orbital finding suggestive of IIH (93% vs 14%). Age modestly correlated with the width of the diaphragm sella (r = 0.53) in the IIH group only.
  
  
  CONCLUSIONS
  The significance of the MRI finding of an empty sella turcica can be determined using a combination of clinical and imaging findings.
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, GA 30322, USA. asainda@emory.edu
authors.forename: Amit M
authors.initials: AM
authors.lastname: Saindane
authors.forename: Paolo P
authors.initials: PP
authors.lastname: Lim
authors.forename: Ashley
authors.initials: A
authors.lastname: Aiken
authors.forename: Zhengjia
authors.initials: Z
authors.lastname: Chen
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Hudgins
mesh_terms: D000293:Adolescent; D000328:Adult; D004652:Empty Sella Syndrome / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D019586:Intracranial Hypertension / Q000175:diagnosis* / Q000209:etiology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult