High resolution ct air cisternography in the diagnosis of small acoustic neuromas

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Abstract
High resolution CT air cisternography was used to examine 38 patients with clinical findings and audiovestibular function studies consistent with a retrocochlear lesion. Four strictly intracanalicular lesions and 10 acoustic neuromas extending medially into the cerebellopontine angle (CPA) cistern by no more than 1 cm were detected and verified at surgery. There was one false‐positive diagnosis produced by a tortuous inferior cerebellar artery branch. The contrast‐enhanced axial scan was positive in only two patients. Both had extension of the tumor into the CPA by 1 cm. In these two cases the axial intravenous (IV) contrast‐enhanced scan provided more information than the air CT. A patient with suspected acoustic neuroma is best examined initially with an IV contrast‐enhanced axial scan followed by CT air cisternography where the contrast study is negative.