Imaging the sella turcica in sheehan syndrome: is there a correlation with clinical presentation?

Sawsen Nouira; Hamza Elfekih; Amel Maaroufi; Koussay Ach; Yosra Hasni; Molka Chaieb

doi:10.1530/endoabs.99.EP677

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Endocrine Abstracts (2024) 99 EP677 | DOI: 10.1530/endoabs.99.EP677

ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)

Imaging the sella turcica in sheehan syndrome: is there a correlation with clinical presentation?

Sawsen Nouira ¹ , Hamza Elfekih ¹ , Amel Maaroufi ¹ , Koussay Ach ¹ , Yosra Hasni ¹ & Molka Chaieb ¹

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¹University Hospital Farhat Hached, Endocrinology Sousse

Introduction : Few studies have considered the natural history of pituitary anatomy in Sheehan syndrome (SS), as seen on magnetic resonance imaging (MRI) or CT scan. An imaging study of the sella turcica was carried out in patients with SS. The aim was to look for correlations between radiological findings and the degree of endocrine insufficiency on the one hand, and diagnosis delay on the other.

Methods: This is a retrospective study carried out between 1977 and 2021 on patients with SS followed at the endocrinology department of the Farhat Hached Hospital in Sousse, Tunisia. Clinical and radiological findings were documented and reviewed.

Results: Fifty-four patients diagnosed with SS were included. The mean age at diagnosis was 47±14 years. The mean diagnostic delay was 15 years. Twenty patients had complete anterior hypopituitarism, 34 with at least one preserved pituitary function. Pituitary imaging was normal in 7 cases. The sella turcica was totally empty in 15 patients, partially empty in 32 cases. A remnant of pituitary tissue was found more frequently (56%; n=22) in those with dissociated hypopituitarism (P≤ 0.005). Patients with an empty sella turcica at the time of diagnosis had a longer diagnostic delay (18vs14 years; P≤ 10^-3).

Conclusion: The presence of a pituitary remnant is inversely correlated with the duration and extent of the disease. The empty sella should be the end point of the process, indicating the necrosis that has occurred. In women whose diagnosis has been delayed, the discovery of an empty sella is frequent.