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• W2028389616 abstract "We have studied the diagnostic value of computed tomography cisternography in the evaluation of altered CSF dynamics and lesions which affects the morphology of the basal cisterns, such as extraaxial tumors in 35 patients. Twenty-two patients received metrizamide for the evaluation of CSF dynamics, mainly of communicating hydrocephalus, 9 for skull base tumors such as pituitary adenomas and CP angle tumors, and 4 for congenital cystic lesions such as porencephaly or arachnoid cyst. Diazepam or phenobarbital was used before intrathecal injection of metrizamide. In most cases, metrizamide was introduced through the lumbar intrathecal route, except for 2 cases which were through cisterna magna puncture and 2 cases into the lateral ventricles via Ommaya's reservoir. Two to 10 ml of metrizamide solution with a concentration of 170 mgI/ml was used. The patients were kept in 30 degrees Trendelenburg position, or kept in the horizontal supine position. Computed tomography with EMI scanner (CT1010) was performed 1, 3, 6, 24, 48 hours and occasionally 72 hours after the injection. In normal CSF dynamics, basal cisterns are clearly visualized one hour after injection. At 3 hours, cisterns are more clearly opacified with metrizamide. At 6 hours, the amount of metrizamide is slightly decreased from basal cisterns. Sylvian and interhemispheric fissures and convexity subarachnoid spaces and sulci become more distinctly opacified. At 24 hours, basal cisterns become almost free of metrizamide and diffuse increased absorption of the cerebral surface and possible cerebral parenchyma are noted. At 48 hours, no metrizamide is detected by CT. The fourth ventricular filling is sometimes seen in normal cases. In abnormal CSF flow pattern, ventricular reflux of metrizamide, persistent or transient, is noted. In such cases, periventricular low density area is often observed on plain CT. In a case shown at Fig. 6, periventricular low density area shows statistically significant increase in Hounsfield units at 6 and 24 hours after metrizamide injection. This suggests periventricular resorption of metrizamide. The site of cisternal block is clearly visualized. Delayed convexity flow is also noted. Detailed morphology of the subarachnoid cisterns can be analysed with the use of CSF enhancement with metrizamide, especially by the 320 × 320 matrix high definition picture. The presence or absence of suprasellar extension of a tumor is exactly diagnosed. A CP angle tumor is also diagnosed as a filling defect. An arachnoid cyst and porencephalic cyst can be diagnosed in relation with CSF flow pattern. The side effects we have observed are headache (10/35), nausea (9/35) and vomiting (6/35). No convulsion has appeared." @default.
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• W2028389616 date "1978-01-01" @default.
• W2028389616 modified "2023-09-25" @default.
• W2028389616 title "Diagnostic Value of CT Cisternography with Intrathecal Metrizamide Enhancement" @default.
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• W2028389616 doi "https://doi.org/10.2176/nmc.18pt2.231" @default.
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