CT atlas of the skull base

Although CT is generally used for lesions of the face, the orbit, the nasal and paranasal cavity, and the skull base, a CT atlas of these regions has not been reported. Furthermore, the skull base, that lies nearly tangential to the conventional axial plane of CT, can not be precisely evaluated on ordinary horizontal pictures. For the purpose of a clear demonstration of the skull-base structures by CT, a model human skull was investigated. The results and its clinical value have previously been reported. For the CT atlas of the skull base, three model human skulls (embedded in agar gel containing iodine in a manner previously reported) were also examined by EMI-CT1010 with a 5 mm thickness. The magnification and wide-window techniques were also used for demonstration. Ordinary-0 sections (scanning plane at 00 to Reid's base line), ordinary-25 sections (+250 to RBL), reverse-20 sections (-200 to RBL), reverse-80 sections (-800 to RBL; coronal sections), and sagittal sections were selected in order to illustrate the anatomical details of the skull base. Pictures of the inner aspect and the outer aspect of the skull base were also provided. Clinically it is very important to recognize osseous change and the relationship between the lesion and the skull base in three dimensions. In evaluating lesions of the skull base and those of the tentorial notch a two-plane CT examination (ordinary-25 sections and reverse-20 sections) is usually used. This method is useful in determining the surgical approach, for instance, to decide between a transsphenoidal approach or intracranial approach for a sellar lesion, or between a subtemporal approach, posterior fossa approach, or combined approach for a lesion of the tentorial notch. It is also helpful to make a map of the lesin on a plain craniogram using this two-plane method in some cases for radiotherapy and stereotactic brain biopsy. (author)