Articles: paranasal-sinuses-diagnostic-imaging.
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While most patients with inflammatory rhinosinusitis are successfully diagnosed clinically, imaging is indicated in patients with recurrent or chronic sinusitis, atypical symptoms and complicated acute sinusitis. Non-enhanced high resolution, thin section computed tomography (CT) is the reference standard in evaluating such patients. ⋯ Contrast MR imaging is preferred for assessing intraorbital or intracranial complications. The radiologist must have a systematic approach to sinonasal CT and generate a clinically relevant report that impacts patient management.
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As endoscopic sinus surgery (ESS) has evolved since its introduction to the United States, so has technology for imaging the sinonasal cavities. Although imaging is most frequently performed for evaluating chronic sinusitis refractory to medical therapy, its uses have expanded beyond inflammatory sinus disease. Multidetector Computed Tomography is the current workhorse for both diagnosis and preoperative planning in prospective ESS patients, while MR imaging remains a complementary tool for evaluating suspected tumors or intracranial and orbital complications of rhinosinusitis. In this article, the authors review current trends and potential future directions in the use of these modalities for sinus imaging.
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Neuroimaging Clin. N. Am. · Nov 2015
ReviewNormal Anatomy and Anatomic Variants of the Paranasal Sinuses on Computed Tomography.
It is imperative for all imaging specialists to be familiar with detailed multiplanar CT anatomy of the paranasal sinuses and adjacent structures. This article reviews the radiologically relevant embryology of this complex region and discusses the region-specific CT anatomy of the paranasal sinuses and surrounding structures. Radiologists also need to know the clinical implications of identifying preoperatively the numerous anatomic variations encountered in this region and prepare a structured report according to the expectations of the referring clinician.
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To evaluate image quality of dose-reduced CT of the paranasal-sinus using an iterative reconstruction technique. ⋯ As compared to filtered back projection, the iterative reconstruction technique allows for significant dose reduction of up to 60% for paranasal-sinus CT without impairing the diagnostic image quality.
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The Onodi cell (sphenoethmoidal cell) is an anatomical variation of the most posterior ethmoid air cell the pneumatizes laterally and/or superiorly to the sphenoid sinus and is intimately in contact with the optic nerve. If it is infected or goes unrecognized during surgery it may result in serious damage to the optic nerve. Nowadays, computed tomographic scans of paranasal sinuses (CT PNS) have been used to detect variations in paranasal sinus anatomy However there is a lack of data about the variations of Onodi cell. ⋯ The prevalence of Onodi cell diagnosed by CT scans was 49.5% (95% CI 44.4-54.5) and the most common pattern was the combined type. This information may be useful for those who perform endoscopic sinus surgery.