Computed tomographic sellar and perisellar evaluation. Use of high-dose continuous contrast infusion

Contrast enhancement provides valuable information in cranial computed tomography. We report the use of high-dose continuous contrast infusion as a means of consistently demonstrating major perisellar cerebral vasculature. This method was utilized in examining 73 patients, and three illustrative cases are presented. We propose that this technique be performed as the initial radiographic procedure in evaluating sellar and perisellar lesions. Results of clinical, laboratory, and CT examinations may necessitate additional studies including sellar complex motion polytomography, cerebral angiography, metrizamide CT cisternography, or pneumoencephalography. However, employing the CT techniques described, the role of invasive neuroradiographic procedures in the preoperative evaluation of the sellar and perisellar region requires reconsideration.