The greatest distance between

The greatest distance between a bottom and a perpendicular lowered from top of a backrest of a saddle on it , makes 13 mm [128]. However definition of the sizes of a Turkish saddle is not enough angiographies of the carotids (marksman), finding out top and a laterposition of both forward cerebral arteries owing to intensive growth of a tumour buy orlistat of a pituitary body: - computer a scanning image and - strengthened (by contrast agent infusion) a scanning image which is finding out diffusion of a tumour of a pituitary body (finger) (it is kindly given D. Fatal, hospital Michael Reese). That gives for diagnostics of a tumour of a pituitary body [129] as at excess of the normal sizes usually there are other signs of its pathology, and at obvious changes by other criteria the sizes of a saddle often remain within norm. Trying to define the sizes of a Turkish saddle more precisely, DuChiro and Nelson [1] for calculation of its volume have suggested to use the width measured on a craniography. According to these authors, the maximum volume of a saddle in norm makes 1100 3 though at other way of calculation the digit almost twice exceeding these [130] has been received. More subjective is the estimation of the form of a Turkish saddle, and to impression transfer about its minimum augmentation apply such terms, as "swelling" or expansion.
There are also disagreements concerning, whether are variants of norm or precursory symptoms of tumours the small thinning or erosion of a cortical layer of the bone forming a firm plate of a saddle, and also a double contour of its bottom surface (a double bottom), that meets at 30 of persons without suspicion on a tumour of a pituitary body [131]. Any of these changes is not, however, pathognomonic for a pituitary body tumour. They can be observed at a syndrome of an "empty" Turkish saddle, the neoplasms sprouting in a fossa, rising of intracranial pressure and in the least expressed kind even at persons without endocrinologic or neurologic signs of a pathology of a pituitary body. These changes get value maxalt only in a combination to others clinical and datas of laboratory. On lateral and pictures of a Turkish saddle can be found out also and the calcareous infiltration centres. Their presence especially in serves area as the weighty indicating on a cranyopharyngioma at which they meet in 50 of cases. On the other hand, at adenomas of a pituitary body calcificats meet not more often, than in 5 of cases. Such changes usually settle down within a Turkish saddle, almost always have the roundish form and are in a capsule of a tumour or a cyst wall. Tomography of a Turkish saddle. The tomography of a Turkish saddle has quickly got extremely great value as a method of specification of the doubtful signs taped on plane roentgenograms. The linear tomography applied in the beginning has given way to a hypocycloidal tomography which gives the best permission and allows to avoid some artefacts inherent to an initial method. Applying sections in the thickness in 1-2 mm, it is possible to find out local sites of erosion or a thinning which are absolutely not visible in plane pictures, to tap tumour diffusion on the basic bone or a sine and to receive representations about anatomy of a sinus of the basic bone. The tomography should be made when on usual roentgenograms find out suspicious changes, and at a hypercosecreting tumour of a pituitary body even in absence of any changes - on usual roentgenograms. At interpreting of little changes on the tomogram care is necessary as to draw an accurate side between early changes and norm variants difficult enough [131]. If at usual roentgenography of a Turkish saddle find out distinct signs of a tumour necessity for a tomography often disappears. Pneumoencephalography. Now diagnostic value of a pneumoencephalography is reconsidered at tumours of a pituitary body and there are disagreements concerning importance of the data received by means of this method, in comparison with the information, which can be received by means of other, non-invasive methods of research (smaller inconveniences [126, 127] see more low), causing to the patient. The pneumoencephalography undoubtedly serves as a fine method of definition of presence and degree tumour diffusions; it promotes also to differentiation and processes. This method is the most reliable and accessible now and concerning diagnostics of a syndrome of an "empty" Turkish saddle. Some neurosurgeons use for a choice of the surgical approach as at appreciable tumour diffusion it can appear necessary face-to-face, instead of transsphenoidal access.