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SUMMARY Three cases of multiple sclerosis, all confirmed pathologically, are described in whom both the unusual clinical features and the CIT scan appearances suggested cerebral tumours. The failure of mass effect reliably to differentiate plaques and tumours on a CT scan is stressed and the literature relating to CT scanning in multiple sclerosis is reviewed."Cerebral" features, notably headache, epilepsy and aphasia are recognised but uncommon in multiple sclerosis and may suggest a diagnosis of cerebral tumour.' Computed tomography of the head (CT scan) in multiple sclerosis has demonstrated enhancing plaques which have been said to be distinguishable from tumours by their lack of mass effect.26 We present three cases of "cerebral multiple sclerosis" in whom cerebral tumours were suspected

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Metrizamide cisternography and computed tomography (CT) have been performed on 22 patients suspected of having pituitary or suprasellar lesions, using a low dose of metrizamide. These patients would otherwise have been subjected to air encephalography. The technique is described and the results are presented. The lesions demonstrated included empty sellae and suprasellar extensions of pituitary tumours. We also identified those patients in whom there was no suprasellar extension of a pituitary tumour. The diagnostic information required was obtained in all cases by a combination of the two techniques and air encephalography was avoided in all but one case. The side effects were mild and no serious complications were encountered. We consider this combination of methods to be very useful for the investigation of pituitary lesions.

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