What it is (overview)

A CT sella turcica without IV contrast is a specialized CT scan (computed tomography) focused on the sella turcica, a small bony “saddle” at the base of the skull that houses the pituitary gland. The pituitary is often called the body’s “master gland” because it helps regulate hormones that affect growth, reproduction, thyroid function, adrenal function, and more.

This is a type of non-contrast brain imaging, meaning no contrast dye is injected into a vein. The scanner uses X-rays and computer processing to create detailed cross-sectional images of the bone and nearby structures. Without contrast, the exam is especially good at showing bony changes, calcifications, and certain structural abnormalities around the pituitary region.

What the results mean in plain language: A radiologist reviews the images to see whether the sella turcica and surrounding skull base look normal in size, shape, and density, and whether there are signs of an abnormal growth or pressure effect. A “normal” result generally means the bony sella region appears typical, with no obvious mass effect or destructive bone changes. An “abnormal” result may show findings that suggest a pituitary-area problem, such as an enlarged or eroded sella, a cyst-like area, calcifications, or another skull abnormality that could relate to pituitary function or nearby structures (including the optic nerves/optic chiasm). Because this is a non-contrast study, small soft-tissue pituitary lesions may be less visible than on MRI; your clinician may recommend additional imaging (often pituitary MRI) depending on symptoms and hormone test results.

When & why it's usually done

Doctors may order a CT scan of the sella turcica without contrast when they need fast, detailed head imaging of the pituitary region—especially to evaluate the surrounding bone or when IV contrast is not recommended. It may be used as an initial test or as follow-up to other exams.

This test is commonly considered when a person has symptoms or clinical concerns that could involve the pituitary gland or nearby structures, such as:

Hormone-related (endocrine) symptoms: unexplained fatigue, abnormal menstrual cycles, infertility, milk discharge from the breast (galactorrhea), decreased libido, erectile dysfunction, unexpected weight changes, heat/cold intolerance, or abnormal growth patterns. These issues may raise concern for endocrine disorders related to pituitary hormone imbalance.

Neurologic or vision symptoms: persistent or unusual headaches, changes in peripheral vision, blurred/double vision, or symptoms suggesting pressure near the optic pathways. Pituitary-region masses can sometimes affect vision because of the gland’s location under the optic chiasm.

Known or suspected pituitary-region mass: evaluation for tumor detection (such as a pituitary adenoma), a cyst, or other structural lesion, especially when looking for bony remodeling or erosion of the sella.

Skull base concerns: assessment of skull abnormalities, calcifications, congenital variations, or bone changes from long-standing pressure effects. CT is particularly helpful for visualizing bone compared with MRI.

When IV contrast is not appropriate: if there is a history of severe contrast reaction, certain medical contraindications, or when a non-contrast study is preferred to answer a specific question (for example, evaluating calcification or bone detail).

Your clinician will interpret CT findings alongside your symptoms, physical exam, and lab work (such as prolactin, cortisol/ACTH, TSH/free T4, IGF-1, LH/FSH) to determine whether further testing or treatment is needed.

Common diseases related to it

• Pituitary adenoma (microadenoma or macroadenoma), including prolactinoma
• Rathke’s cleft cyst and other benign cysts near the pituitary
• Craniopharyngioma (often associated with calcifications and cystic components)
• Empty sella syndrome (partially or completely empty-appearing sella)
• Pituitary apoplexy (sudden hemorrhage/infarction in a pituitary tumor; CT may help in urgent settings)
• Sellar or parasellar skull base abnormalities (bony remodeling, erosion, congenital variants)
• Hypopituitarism (may prompt imaging to look for structural causes)
• Acromegaly or Cushing disease (conditions often caused by pituitary tumors; CT may be part of evaluation)

Health goals where it may help

• Clarifying the cause of hormone imbalance (supporting evaluation of endocrine disorders linked to the pituitary gland)
• Evaluating persistent headaches or vision changes when pituitary-region pathology is a concern
• Detecting or characterizing pituitary-area tumors or cysts (especially when bone detail or calcification matters)
• Assessing skull base anatomy and identifying structural deformities that may affect nearby nerves and vessels
• Planning next steps in care (deciding whether pituitary MRI, hormone testing, endocrinology referral, or neurosurgical consultation is appropriate)
• Monitoring known sellar/parasellar lesions over time when non-contrast CT is clinically indicated