Normal Computed Tomographic Anatomy of the Cisterns and Cranial Nerves
When one examines a routine CT scan, three facts are obvious : 1/the cisterns are — thanks to the low absorption values of the cerebrospinal fluid (CSF) — immediately visible ; 2/ intravenous injection of iodine contrast medium enhances the absorption values of the cistern vascular structures (basilar artery in the posterior fossa, polygone of Willis in the suprasellar cisterns, middle cerebral arteries in the sylvian fissures) ; 3/ posterior fossa cisterns are frequently the site of artifacts which prevent an accurate interpretation of the CT sections at this level ; this is due to their small size and their proximity to structures with different densities (petrous bone, mastoid cells) which induce partial volume effect. When compared with an anatomical section at the same level, it becomes evident that a routine CT scan leaves out several fine anatomical structures. For these reasons, a sharp delineation of the morphology of the cisterns in CT is only possible when they are dilated.
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