870 



HAKVEY G. BECK 



cases of hyperpituitarism (acromegaly and gigantism) or hypopituitarism 

 (dystrophia adiposogenitalis) may occur without demonstrable sellar 

 deformation, and, that in a considerable proportion of cases of hypophyseal 

 dystrophy no X-ray evidence of sellar bone lesion is found. 



However, the recognition by means of X-ray of structural alteration 

 of the sella turcica is of great importance, especially in distinguishing 

 the neoplastic from the aneoplastic form of the disease. 



X-ray Bella. In order to determine what constitutes a pathological 

 abnormality in the size, shape and general outlines of the sella turcica, 



Fig. 2. Sella normal in size and general outline. ( Rontgenogram by Dr. John 

 Evans. ) 



one must be familiar with its normal anatomical outline and dimensions 

 and the normal variations. Keith's skeletal measurements for the normal 

 sella average 10-12 mm. anteroposteriorly, 14-15 mm. transversely and 

 s mm. in depth. Profile radiographic measurements exceeding 15 mm. 

 anteroposteriorly and 10 mm. in depth may be looked upon as indicating 

 an enlargement (dishing). For a detailed and comprehensive study of the 

 anatomical outlines and measurements of normal sellse of different ages 

 with their average dimensions, Schiiller's treatise should be consulted. 



Oppenheim (a) (181)!)) was the first to make a diagnosis of hypophyseal 

 tumor in a case of acromegaly by means of the X-ray. The rontgenogram 

 showed a widening of the sella turcica. Important contributions to the 



