The technique of intrathecal enhancement using metrizamide (Amipaque) combined with CT imaging enables both the morphologic and dynamic (serial) evaluation of the intracranial cerebrospinal fluid pathways. Three distinct metrizamide CT cisternographic patterns (delayed, intermediate, and normal) emerge in pediatric patients with hydrocephalus. The findings correlate well with radionuclide cisternographic patterns; however, CT also provides excellent morphologic definition.