Learning objectives
Review the radiological techniques for the sinonasal region: Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Cone Beam Computed Tomography (CBCT).
Provided a detailed description of sinonasal radiological anatomy.
Structured reporting in the sinonasal CT.
Background
Preoperative CT is mandatory in surgical planning prior to endoscopic surgery. Sinonasal CT allows the identification of anatomic variants that predispose patients to surgical complications. These critical areas, however, are not regularly described in the preoperative radiological report.
This educational presentation will explain normal anatomy and highlight common anatomic variants of the paranasal sinuses, emphasising those predisposing to surgical complications.
Findings and procedure details
IMAGING TECHNIQUES:
CT: best modality.
CT imaging of the paranasal sinuses has become the standard of care for preoperative planning. Helical CT allows for rapid acquisition and multiplanar reformations. Unenhanced axial images are typically obtained at 0.625 mm intervals, with reformatted images in the coronal and sagittal planes obtained at 1–2 mm intervals. Both high-resolution bone and soft-tissue algorithms should be obtained in all three imaging planes.
MRI: provides an excellent characterization of soft tissues.
MRI can discern secretions and mucosa from masses. It is...
Conclusion
It is mandatory for the radiologist to know the normal anatomy of sinonasal CT. The routine utilization of preoperative CT allows the opportunity to identify important anatomic variants related to surgical complications.
Personal information and conflict of interest
E. Marín Díez:
Nothing to disclose
J. Viera-Artiles:
Nothing to disclose
M. Arroyo Olmedo:
Nothing to disclose
A. Berasategui Criado:
Nothing to disclose
S. M. Bretos Azcona:
Nothing to disclose
C. Cantolla Nates:
Nothing to disclose
M. Barrios López:
Nothing to disclose
M. J. Galante Mulki:
Nothing to disclose
E. Julián Gómez:
Nothing to disclose
References
1. Expert Panel on Neurological Imaging; Hagiwara M, Policeni B, Juliano AF, Agarwal M, Burns J, Dubey P, Friedman ER, Gule-Monroe MK, Jain V, Lam K, Patino M, Rath TJ, Shian B, Subramaniam RM, Taheri MR, Zander D, Corey AS. ACR Appropriateness Criteria® Sinonasal Disease: 2021 Update. J Am Coll Radiol. 2022 May;19(5S):S175-S193.
2.William T. O’Brien, Sr,Stefan Hamelin, andErik K. Weitzel.The Preoperative Sinus CT: Avoiding a “CLOSE” Call with Surgical Complications. Radiology2016281:1,10-21.
3. Huang BY,Lloyd KM,DelGaudio JM,Jablonowski E,Hudgins PA.Failed endoscopic sinus surgery: spectrum of CT...