CT in occult disease of the skull base and basilar foramina

Current generation CT with its high resolution technology, its capability for soft tissue and bone imaging through an expanded gray scale, its feature of thin section imaging (1.5 mm cuts), and its capacity for multiplanar imaging (axial, direct coronal, coronal, and sagittal reformations, etc.) bring a truly unique element to radiologic evaluation of the skull base and basilar foramina. CT modifications continue to develop, such as dynamic scanning. Thus CT provides the possibility of improved radiologic diagnosis in a clinically problematic area--the recognition of occult disease, invariably tumor, involving the skull base, the neurovascular foramina that penetrate it, and portions of the subjacent visceral cranium and the suprajacent brain. The purpose of this manuscript is to demonstrate and define a role for CT in the possible solution of this problem. Equally, a role for the selective and continued use of conventional radiology and other imaging modalities to both guide and complement CT is considered.