Metrizamide computed tomographic cisternography: A high-yield diagnostic procedure for chiasmal syndromes with equivocal computed tomographic or magnetic resonance scans

Eight patients with chiasmal syndromes that could not be characterized despite high-resolution computed tomographic (CT) evaluation of the chiasm and suprasellar cistern were evaluated by metrizamide computed tomographic cisternography (MCTC). In all cases, the MCTC was essential in establishing the presence or absence of a structural chiasmal lesion. Although Magnetic Resonance Imaging (MRI) has largely supplanted MCTC as the procedure of choice in CT-negative chiasmal syndromes, the utility of intrathecal contrast computed tomography with cerebrospinal fluid analysis in evaluating chiasmal involvement in pituitary adenomas, craniopharyngiomas, gliomas, and particularly in unusual inflammatory lesions of the chiasm, make it a useful procedure to retain in one's diagnostic armamentarium.