“CT is the imaging method of choice for the paranasal sinuses . Coronal CT imaging gives the best overall anatomic detail of the paranasal sinuses and can be achieved either with prone direct coronal imaging or can be reformatted from thin-slice axial images. Contrast enhancement is not generally needed for routine sinus imaging. Sinus radiographs are inaccurate in a high percentage of patients and have been supplanted by CT imaging .
Magnetic resonance imaging (MRI) is currently used for evaluation of sinus disease as a complementary study in cases of aggressive sinus infection with ocular/intracranial complications or in the evaluation of a sinonasal mass. Because of its cost, longer imaging time, and lack of bone detail, it has not been considered the imaging method of choice for routine sinus imaging. Recent public health concerns regarding the dramatic and ever-increasing usage of CT imaging and emphasis on reducing medical radiation exposure may lead to consideration of alternative imaging techniques. One study suggests that MRI-based Lund-Mackay scores did
not show a statistically significant difference compared to CT-based scores in the same patients .”
“As has happened in all facets of neuroimaging, cross-sectional imaging has dramatically changed our approach and understanding of the anatomy and pathology of paranasal sinuses. We have moved away from plain film radiographs to modern high-resolution sinus computerized tomography (CT) and magnetic resonance imaging (MRI) that helps us better depict underlying normal anatomy and evaluate pathology. Recent advances in PET/CT imaging have introduced a physiologic aspect to anatomical imaging and holds promise to better stage and restage head and neck tumors. In this article, we describe the various imaging techniques, concerns, advantages and disadvantages of the individual techniques, and provide an overview of the various pathologies involving the paranasal sinuses.”
“Sinonasal disease is one of the most common clinical head and neck pathologies. The majority of sinonasal pathology is inflammatory with neoplasms comprising approximately 3% of all head and neck tumours. Although sinus tumours are rare, they portend a poor prognosis, often due to advanced disease at diagnosis. Like most neoplasms, early detection improves prognosis, therefore clinicians and radiologists should be aware of features separating tumours from inflammatory sinus disease. This article reviews the anatomy, clinical features, imaging findings, treatment and histopathology of selected sinonasal tumours. Benign neoplasms reviewed include osteoma, inverting papilloma, and juvenile nasal angiofibroma. Malignant neoplasms reviewed include squamous cell carcinoma, the minor salivary gland tumour, adenoid cystic carcinoma, adenocarcinoma, melanoma, lymphoma, and olfactory neuroblastoma (esthesioneuroblastoma).”
“Pediatric sinonasal anatomy changes and develops from birth to adolescence. This article elucidates the normal anatomy and patterns of development in the pediatric population. Issues in pediaric sinusitis include indications for imaging, the nonspecificity of sinus opacification, and the importance of clinical information. Sinonasal physiology is briefly discussed to offer insight into the interpretation of radiographic findings. Cystic fibrosis, polyps, and choanal atresia, representing the spectrum of common pediatric sinonasal inflammatory disorders are illustrated, and the spectrum of orbital and intracranial complications of sinusitis is reviewed.”
Children’s and Emory users, please contact Emily Lawson for article.
For more PubMed results on sinonasal imaging.