Magnetic resonance (MR) imaging has made it possible to evaluate the s
kull base in one primary screening examination. In most cases, MR imag
ing also serves as the definitive imaging study. In some traumatic or
congenital lesions or both, computed tomography (CT) and conventional
radiographs may be preferred or may be needed to supplement the MR ima
ging examination. This article discusses the pathology of the skull ba
se, particularly in the evaluation of suspected neoplasms. Optimal ima
ging of the skull base requires a minimum of two planes of section, ty
pically with and without gadolinium contrast enhancement.