Radiology
The main radiological finding of SS is the image of an empty sella (around 70% of patients) or partially empty sella (30%). The time-dependent evolution of the findings on magnetic resonance (MR) imaging in SS has been described and begins acutely with nonhemorrhagic changes in signal intensity consistent with central infarction, along with peripheral and heterogeneous central enhancement in an enlarged pituitary gland. The findings are consistent with patchy central ischemic necrosis in an enlarged gland and are followed by pituitary gland atrophy and an empty sella. These findings on MR imaging characterize SS and provide early confirmation of the clinical diagnosis.