MRI Scan Angiography Cisternography Without Contrast

MRI cisternography is a specialized MRI technique that produces high‑resolution images of cerebrospinal fluid–filled spaces (cisterns) and nearby cranial nerves. It uses heavily T2‑weighted or constructive interference sequences to accentuate CSF, aiding detection of CSF leaks, arachnoid cysts, cranial nerve compression, and posterior fossa lesions. It’s usually noninvasive without contrast; intrathecal gadolinium can be used when precise leak localization is required.

MRI cisternography costs vary widely by country and facility: in the US private settings roughly $700–$3,000; in the UK it’s usually free on the NHS but private scans can run about £300–£1,200; in India typical private fees range ₹3,000–₹20,000. Final price increases if contrast agents, sedation, specialist radiologist fees, or inpatient services are required.

An MRI angiogram of the head without contrast is a noninvasive MRI technique (commonly time‑of‑flight) that visualizes cerebral arteries using blood‑flow signals instead of injected dye. It evaluates aneurysms, stenosis, arteriovenous malformations and vessel anatomy. No intravenous gadolinium is needed, lowering risk, though it can be less sensitive for very slow flow, tiny vessels, or complex lesions.

A normal CT cisternography shows prompt, symmetric filling of the ventricles, basal cisterns and subarachnoid spaces with intrathecal contrast, without extravasation outside the dura or through skull‑base or spinal foramina. There is no focal contrast collection, meningeal abnormal enhancement, or anatomical defect—indicating intact CSF pathways and no radiographic evidence of a cerebrospinal fluid leak or abnormal communication.

Position the patient supine for initial cisternography with the head supported in a neutral position; acquire anterior–posterior and lateral views. After intrathecal injection, obtain serial supine images immediately and perform delayed imaging with the patient upright to promote cranial tracer spread and reveal CSF leaks. Additional head rotation or targeted positioning can help localize focal leaks.

A cisternogram typically spans several hours and may extend to 24–48 hours. The test starts with a lumbar puncture to inject a radiotracer (about 30–60 minutes), followed by multiple imaging sessions—often at 1–4 hours and again at 24 hours, sometimes 48 hours. Each imaging session lasts 20–60 minutes; total time depends on the clinical indication and findings.