MRI of the paranasal sinuses makes it possible to visualize inflammatory, tumor and other diseases. An MRI of the sinuses is prescribed by the attending physician, after other studies have been carried out that have not given the desired results.
The sinuses are voids that are located in the bones of the skull, covered inside with a mucous membrane. They are intended to humidify the air when a person breathes and also to form the voice. When any pathological processes develop in the paranasal sinuses, a person may experience symptoms such as headaches, a decrease in general physical condition, nasal congestion. The appearance of these symptoms in a person is sufficient for a visit to an otolaryngologist and undergoing diagnostic tests.
Nasal tomography is required to visualize extensive inflammatory processes. Tomography of the sinuses is not the most main way to survey this area. With the modern level of medicine, the doctor makes an accurate diagnosis of this area after undergoing an X-ray or computed tomography, and an MRI of the nose is prescribed in the most complex and severe cases.
Indications for MRI of the sinuses
They are referred for an MRI of the sinuses in the following cases:
- unspecified headaches;
- inflammatory processes in this area;
- allergic rhinitis;
- suspicion of the formation of benign and malignant tumors;
- there are deviations that are congenital in nature;
- suspicion of cyst formation;
- Availability allergic reactions appearing on external irritants;
- anomalies in the structure.
Tumors and inflammatory processes are best seen on MRI of the sinuses. MRI of the paranasal sinuses and nasopharynx is most effective in cases where it is necessary to study the mouths of the ducts between the nasopharynx and sinuses.
What does an MRI of the sinuses show?
During the examination, it is possible to visualize the sinuses together with their internal lining, as well as the mouths of the ducts, which are located between the paranasal sinuses and the nasal cavity itself. This method makes it possible to see the presence of inflammatory reactions, cystic formations, as well as deviations and pathologies in the structure of the bones of the skull and paranasal sinuses. The doctor has the opportunity to identify and examine the smallest pathological foci, which is impossible when examined in any other way.
Carrying out MRI
MRI of the nose is performed using special programs aimed at identifying pathologies in the structure and functioning of the paranasal space. Mucosal structures, bone and cartilage tissues are examined in great detail.
MRI with contrast
Tomography of the nose with the introduction of contrast agents is mainly performed when there is a suspicion of the presence of cancer. is a drug based on gadolinium. It is administered intravenously before the examination begins. Using contrast in the resulting images, tumors and their boundaries can be visualized with the greatest accuracy.
Such a study takes from 30 to 40 minutes. Before undergoing the study, it is recommended to undergo screening for possible allergic reactions.
There are a number of minor contraindications:
- the presence in the human body of elements containing metal, such as, for example: all kinds of implants and prostheses, the presence of a pacemaker, etc.;
- claustrophobia;
- hyperactivity or various pains in the body, during which it is simply impossible to remain at rest for a long time;
When performing tomography with the introduction of contrast, the list of contraindications increases slightly:
- women during pregnancy and nursing mothers;
- patients with renal failure;
- intolerance to the components of contrast agents.
The results obtained during the examination are deciphered by a specialist who analyzes the data received. The conclusion will necessarily indicate as accurately as possible any minimal deviations from the normal state. As a rule, depending on the clinic, such a conclusion, together with photographs, is issued within 20-30 minutes. after completing the study.
One of the most advanced and high-tech medical methods is magnetic resonance imaging. What does an MRI of the sinuses show? Such a high-tech device allows you to thoroughly examine various parts of the human body and identify various disorders and pathologies.
Such in-depth diagnostic techniques help to increase the effectiveness of treatment of any, even the most complex, disease.
MRI of the paranasal sinuses can be considered one of the most accurate research techniques. Demand of this type diagnosis is determined by the presence of a large number of bone-type structures in the human skull.
The method makes it possible to visualize in detail the appearance of the patient’s skull and identify the slightest pathological changes. MRI can also be performed using x-ray methods, which include radiography and computed tomography. It is possible to carry out.
Various types inflammation and tumor growths are much better determined when performing MRI of the paranasal sinuses. The procedure is particularly effective when studying the state of the end of the ducts located between the space of the nasopharynx and.
If doctors have any assumptions about the presence of cancerous tumors in the paranasal area, an MRI of the sinuses is performed using special contrast agents, which help to accurately determine the location malignant neoplasm.
Carrying out this type of diagnosis is characterized by its duration and increased complexity.
After a contrast agent is injected into the patient’s vein, the study begins and lasts about half an hour. Immediately before the start of the study it is necessary to carry out a number of checks regarding the likelihood that the patient will have an allergic reaction to the contrast agent.
If you skip this step, the patient may die due to overlap. respiratory tract as a result of allergic edema.
MRI is usually used if the patient has such manifestations as:
- Bright allergic symptoms to some external stimuli.
- Doctors suspect that the patient has tumor formations or cysts in the sinus area.
- Abnormal structure of the sinuses in the paranasal space.
This diagnosis is more often used in situations where the patient has pain in the head in the frontal, frontal and paranasal sectors of the skull.
In some cases, defects that are detected by MRI are symptomatic through tinnitus and discomfort during swallowing.
MRI of the paranasal sinuses is performed using an ordinary tomograph using special software. This type of diagnosis is entirely aimed at identifying any type and form of pathology in the structure and functioning of the paranasal space. Due to the presence of a large number of different bone and cartilage tissues, as well as mucous structures, this part of the skull requires a special careful approach during examination.
What is better for the sinuses - MRI or CT?
To determine the correct diagnosis it is necessary to use the best remedy for studying spaces around the nasopharynx .
Before undertaking such procedures, it is recommended to study the advantages and disadvantages of MRI and CT.
The advantages of MRI include:
- harmlessness due to the absence of x-rays and radiation;
- the procedure provides a three-dimensional detailed image for research;
- contrasted blood movement;
- there are no distorted images of bones;
- high differentiation of the soft tissues of the body.
The disadvantages of MRI include:
- the resulting image often shows body movement during breathing, which can negatively affect the diagnosis of lung diseases;
- unreliability for diagnosing the presence of some bone defects;
- high cost of the procedure;
- impossibility of diagnostics for patients with metal prostheses or implants, as well as for patients with installed pacemakers.
Advantages of CT:
The main disadvantages of CT:
- there is a small possibility of oncological diseases due to high doses of x-ray radiation;
- the procedure may negatively affect intrauterine development fetus in pregnant women, which makes it undesirable for such patients;
- the possibility of allergies due to the use of iodine-based contrast agents.
When choosing between MRI or CT of the sinuses, you should be guided by the doctor’s recommendations, expediency, and financial side question.
By and large, the effectiveness of diagnostics, both with MRI and with CT, is at the same level.
Using both methods, it is possible to accurately diagnose various malignant or benign neoplasms, identify defects in the structure of the nasopharynx, find foci of inflammatory processes, as well as pathologies of the mucous membranes.
The CT procedure is significantly cheaper than MRI. For this reason, magnetic resonance imaging studies should be carried out only in situations where there are certain serious arguments on the part of the attending physicians.
The examination process and determination of the final diagnosis
The procedure makes it possible visualization of the structure of the nasal sinuses, as well as their internal lining.
In addition, the orifices of the ducts located between the paranasal sinuses and the nasal cavity can be visualized.
This research method helps to diagnose various inflammatory processes, cystic neoplasms, as well as certain pathologies of the development of the paranasal sinuses and cranial bones.
The method allows the doctor to identify the most minor defects and pathologies, which is impossible to do when using other diagnostic methods.
In situations where the patient simply cannot resist making certain bodily movements, he is asked to take certain sedatives. The entire scanning procedure takes on average 10 minutes. If no contrast agent is used, the study patient will not experience any pain or discomfort.
The patient should not be frightened by the fact that the device itself makes a specific sound during the scanning process, reminiscent of cracking ice.
During the procedure itself, the patient is completely alone in the room.
In the next room there are doctors who monitor everything and monitor the received images and then study them.
At the end of the procedure, the patient can return to his home or go to work.
The cost of such a procedure varies greatly depending on the region, as well as on the pricing policy of the medical institution. On average, the cost of an MRI of the sinuses varies between five thousand rubles.
After completing the procedure, the specialist will prepare a detailed report on the results of the study, which will describe the detected abnormalities and pathologies. A good result of this type of study is when it was not possible to identify any pathologies or abnormalities in the structure of the sinuses and nasopharynx.
The MRI procedure allows you to identify and diagnose disorders and diseases in the area of the maxillary sinuses, such as:
Bottom line
Based on the information presented, we can conclude that CT and MRI are types of medical research giving the most complete picture regarding the physiological state of the body systems and its organs.
Each method has certain advantages and disadvantages. The final decision on the assignment of a specific type diagnostic study accepted by the attending physician, based on the available results of the preliminary diagnostic process of the patient, as well as his age, gender and some characteristics of the body.
If the patient has no contraindications, then most often doctors prefer the MRI procedure. In individual cases, the attending physician may decide to carry out both procedures in parallel, since each of them provides its own information.
Magnetic resonance imaging (MRI) is used to examine the paranasal sinuses to identify pathology of the sinus cavities, changes in the mucous membrane and soft tissues, causes liquid formations. MRI of the nasal sinuses (frontal, maxillary (maxillary), sphenoid, ethmoid sinuses) is performed for both adults and children in the absence of contraindications. Allows you to definitively establish a diagnosis for a number of diseases where the capabilities of other studies are limited.
The essence of the method and scope
When performing an MRI of the paranasal sinuses, a strong magnetic field is applied to the patient's head area. During the examination, high-intensity radiofrequency pulses are applied. The result of their influence is a change in the internal magnetization of the tissues of the subject’s body. A nuclear magnetic resonance effect occurs with a subsequent return to the original state. These changes are repeatedly recorded separately for each point of the studied area of the patient’s body. The device allows you to obtain images in various projections.
The resolution of MRI makes it possible to obtain high-quality layer-by-layer images, which makes it possible to separate healthy tissues from pathologically altered ones. A special feature of MRI is the high accuracy of imaging soft tissues, vascular and other formations filled with fluid. It is advisable to examine the condition of bone tissue using other methods (x-ray).
Additional use of a contrast agent is also used. A paramagnetic substance is injected intravenously, the presence of which in small vessels makes it possible to obtain a more enhanced image compared to surrounding tissues (for example, during tumor growth, bone destruction). This allows us to determine the boundaries and prevalence pathological process. In a number of tumors, there is an increased accumulation of contrast agent in the area of the neoplasm, which indicates the proliferation of the vascular network in the pathologically altered tissue.
MRI is performed if there is suspicion of:
- benign, malignant neoplasms;
- inflammatory changes in the sinuses of an infectious, allergic nature;
- damage to the bone structure due to tumor growth;
- birth defects;
- cavitary cystic formations with liquid contents;
- hemorrhage;
- foreign bodies that do not contain metals;
- the presence of purulent contents in the sinus cavity.
MRI can reveal the location, size pathological changes, relationships with surrounding tissues and organs. Contrast allows you to see the intensity of blood supply and the location of blood vessels.
Simultaneously with the study of the sinuses, it is advisable to conduct an MRI of the nose to determine possible reason sinus pathology: structural anatomical defects (deviated nasal septum, formations that impede outflow from cavities). With MRI maxillary sinuses, frontal sinuses, this study is mandatory; it allows you to most accurately determine the diagnosis and prescribe appropriate treatment. And also decide on the advisability of surgical correction.
MRI allows you to get an accurate picture of changes in the lattice and sphenoid sinus, which is difficult with other types of research due to the anatomical location of these structures.
Contraindications for the study
MRI makes it possible to definitively establish a diagnosis for a number of diseases.
MRI cannot be performed on all patients. There are absolute contraindications in which the study cannot be performed and it should be replaced by another diagnostic method. Such contraindications are metal-containing structures implanted into the body.
The study cannot be carried out if:
- pacemaker without magnetic protection;
- automatic drug dispenser;
- insulin pump;
- metal vascular clips;
- artificial heart valves;
- hearing aid;
- elements of bone metal synthesis;
- foreign bodies containing metals;
- artificial
Conductive electricity elements under the influence of eddy currents generated in high magnetic fields, are capable of sudden heating, which can lead to burns of the tissues surrounding implants and prostheses. Pacemakers can be disabled, which will pose a direct threat to the patient's life. Hearing aids also stop functioning, and there is a risk of damage to nerve endings.
The presence of tattoos on the body, which were created using metal-containing inks, also affects the results of the study. Metal particles create interference, degrade image quality, cause discomfort and pain. Titanium implants are not magnetized and do not interfere with high-quality and safe examination.
IN clinical practice situations arise when the likelihood of complications of the disease, as well as a direct threat to the patient’s life, exceeds Negative consequences research. In this case, doctors, after weighing the risks and taking advantage of other studies, can decide to conduct this examination. Such contraindications are called relative.
MRI is relatively contraindicated:
- fear of being in a closed space;
- the likelihood of developing seizures;
- the patient’s anxiety, as well as his serious condition;
- decompensated diseases of cardio-vascular system, respiratory organs;
- body weight exceeding 120-180 kg (for various devices).
If there is shortness of breath, patients cannot lie down due to a sharp deterioration in breathing. MRI of the nose and paranasal sinuses uses contrast agents containing the metal gadolinium (Magnevist, Omniscan). They lack iodine, so the likelihood side effects, allergic reactions are significantly reduced. Contraindicated. At breastfeeding It is advisable to refrain from feeding the child for 24 hours after the MRI.
Features of the procedure in adults and children
No special preparation is needed before the study. When performing an MRI with contrast, you should not consume food, drinks, or water for 6 hours before the procedure. Before the examination, you must remove all jewelry and metal products (watches, glasses, removable dentures and hearing aids).
Sequence of examination:
- The patient needs to lie on the table with his back down.
- Medical personnel fix the head with special fasteners that do not contain metal elements.
- The table with the patient is placed in a ring-shaped contour at a level corresponding to the study area.
- Scanning is carried out, results are processed and displayed on a computer installation under the supervision and control of a doctor (an average of 25 minutes).
- In contrast-enhanced MRI, the drug is administered intravenously in a continuous or one-time mode, and the results are recorded before and after the administration of contrast.
- After completing the examination, with the help of medical staff, the patient is freed from the fixing elements and rises from the table.
Upon completion of the procedure, the doctor assesses the well-being and condition of the subject.
For this study no age restrictions. Technical difficulties arise when examining young children, as a result of their possible anxiety and inability to spend a certain amount of time in a supine position without moving. In this case, as well as when examining adults with increased anxiety, uncontrolled motor activity, preliminary use is acceptable sedatives as prescribed by a doctor.
Thus, MRI of the paranasal sinuses is a modern, highly effective method for diagnosing the pathology of the paranasal sinuses, especially in the early stages of disease development. High image accuracy allows for timely diagnosis of pathology and monitoring the effectiveness of treatment. As a result, it is possible to prevent the progression of the pathological process and the development possible complications and also maintain the patient's health.
Computed tomography of the sinuses is one of the most informative diagnostic methods used in otorhinolaryngology.
CT examination provides information about morphological changes tissues, structural disorders, injuries and neoplasms in the nasal cavity. High accuracy of the examination is achieved by exposing the nasopharynx to X-rays, which form a three-dimensional image of the nasal cavity.
Computed tomography of the sinuses is a highly accurate method for diagnosing diseases and injuries of the nasopharynx and sinuses. The images obtained during the procedure make it possible to establish and differentiate the diagnosis and serve as the basis for prescribing effective therapy.
High information content and ultra-precision compensate for the only drawback of CT - x-ray radiation, the dose of which is lower than that of x-rays.
Depending on the method of performing the procedure, CT scans of the nasal cavity are divided into types. The main types include:
- Standard CT without contrast.
- CT scan of the nasal cavity with contrast. In this case, the patient is injected with a contrast agent containing iodine, which better reveals soft and bone tissue, cartilaginous connections of the cavity. Contrast is mainly used to increase the information content of the procedure, as well as in cases where there is suspicion of a tumor.
- Nasopharyngeal MSCs. Multislice computed tomography is also performed using X-ray exposure, as CT, but refers to a more effective diagnostic method.
MSCT of the paranasal sinuses allows you to obtain up to 300 images per revolution of the device (while CT takes from 1 to 10 images). The image quality of MSCT is higher than that of standard computed tomography.
Main indications for CT scanning
Diagnostics of the nasopharynx using computed tomography is prescribed for diagnosis, before and after the therapy used. The main reasons for prescribing the procedure are:
- inaccuracy of X-ray images;
- chronic inflammatory processes of the nasopharynx and paranasal sinuses;
- the presence of dacryocystitis - inflammation in the lacrimal sacs, which also affects the lacrimal ducts;
- previous injuries, especially those accompanied by a deviated septum;
- the presence of neoplasms (polyps, malignant and benign tumors, cysts, etc.);
- abnormal structure of the skull, affecting the condition of the nasopharynx;
- Availability foreign objects in the nasal cavity;
- past infectious diseases;
- transmission of diseases such as rhinitis, sinusitis, liquorrhea.
Computed tomography of the paranasal sinuses is also indicated for headaches (especially when tilting the head), pain in the eyes. Such symptoms may indicate inflammatory processes in the maxillary sinuses (for example, with sinusitis). The procedure is also prescribed before surgical intervention to assess the structure and condition of the nasal cavity.
In the presence of tumor-like neoplasms, a CT scan of the nasal cavity will determine the etiology of the tumors - whether they are benign or malignant. Such a study also helps to differentiate the nature of polyps and identify the cause of their occurrence in the paranasal sinuses or nasopharynx.
Key advantages of the method
Diagnosis of the nasal cavity using CT has significant advantages. These include:
Cyst ( White spot on the left) in the picture of the sinuses
- high information content and quality of images (diagnosis is made using high-resolution 3-D images);
- low radiation exposure when diagnosing the nasopharynx in comparison with x-rays;
- speed of scanning and minimal time for research (the procedure takes from several minutes to half an hour);
- painlessness and a minimal list of contraindications.
Main contraindications for use
In some cases, diagnosis of the paranasal sinuses using computed tomography is not carried out. The list of contraindications is minimal, since the procedure is safe and painless. The main contraindications for the examination include:
- pregnancy (especially the first trimester);
- lactation period is a relative contraindication (breastfeeding is prohibited for 24 hours after the examination);
- excess body weight (from 180 kg and above), since the device has a restrictive limit;
- allergic reactions to contrast agent;
- age up to 7 years (the procedure is prescribed only for health reasons).
Diagnosis of the nasopharynx using computed tomography may be prohibited if there is diabetes mellitus, melanomas, as well as in pathologies thyroid gland, kidneys, liver, etc.
Specifics of CT scanning of the nasal cavity
Patients scheduled for examination of the maxillary sinuses and nasopharynx in general should undergo preparation for a CT scan. Preparation involves collecting data from the patient about the presence of existing diseases, taking medications, etc.
In addition, the radiologist may ask you to remove metal objects (jewelry, watches, removable dentures etc.). If the examination of the maxillary sinuses is performed using contrast, the substance is administered intravenously 30-45 minutes before the procedure.
The procedure algorithm is as follows:
- The patient is placed on the tomograph couch (on his back or face down). The chin should protrude forward so that the X-ray tubes can better scan the nasal cavity.
- The patient is immobilized - this can be done with special rollers and belts. You must remain calm throughout the examination to ensure that the images are not inaccurate.
- The patient is sent into the tomograph capsule through a portal where detectors and X-ray tubes rotate. With their help, slices are created that are converted into a three-dimensional image.
Modern equipment allows the examination to be done quickly - the duration can be from several minutes to half an hour.
Imaging of the sinuses during MRI (video)
MRI of the nasal cavity as an alternative to CT
In some cases, a computed tomography scan is not possible. In such situations, an MRI of the paranasal sinuses is prescribed. Magnetic resonance imaging makes it possible to establish a diagnosis with higher accuracy due to the increased information content of the image.
When performing an MRI of the nose, a magnetic field is used, which shows the structure of the nasopharynx, the morphological structure of tissues and neoplasms in the cavity.
MRI of the paranasal sinuses - safer diagnostic method, since the patient is not exposed to x-rays. Therefore, this procedure can be performed by people with melanoma, women during menstruation or pregnancy.
The main contraindication to MRI of the paranasal sinuses is the presence of metal implants in the patient (pacemakers, endoprostheses, hearing aids in the middle ear, etc.). This is because the magnetic field can damage the implant. If the examination is carried out using computed tomography, then there are no such contraindications.
Magnetic resonance imaging is not the main type of examination of the nasal cavity and paranasal sinuses and is used in cases where other diagnostic methods are not sufficiently informative.
The paranasal sinuses or sinuses are located around the nasal cavity and are bony cavities that are normally filled with air. They are covered with epithelial tissue and serve to humidify and warm the air inhaled by a person and take part in the formation of the voice.
Main indications for MRI of the sinuses:
MRI shows lesions in soft tissues: the nasal mucosa and paranasal sinuses. The study is not very informative in assessing the condition of bone structures. Therefore, in the diagnosis of diseases of the paranasal sinuses, it plays an auxiliary role and is performed for complications of sinusitis or if a cancerous process of the nasal cavity and paranasal sinuses is suspected.
The procedure is also prescribed when other diagnostic measures have not been effective or require clarification. The examination is carried out in the following situations:
- Frequent headache unknown etiology. If, as part of the preliminary diagnosis, it was not possible to determine diseases of the ENT organs, then it is recommended to perform an MRI of the paranasal sinuses in conjunction with a study of the brain;
- There is a suspicion of the development of a benign or malignant neoplasm. The tomograph visualizes the boundaries of the tumor and the degree of its relationship with the paranasal tissues. The type of contrast filling suggests the nature of the formation;
- If a computed tomography scan was able to determine the presence of changes in the sinuses, but the doctor did not determine their nature. In this case, an MRI of the sinuses will help determine what caused the darkening in the images;
- Recurrent course of sinusitis, frontal sinusitis, which can be caused by a cyst or polyp. MRI of the paranasal sinuses will help identify even small formations.
Advantages of the MRI method of the sinuses
MRI of the paranasal space is a painless diagnostic method that allows you to determine even minor deviations in the structure of tissues. The study visualizes well soft fabrics, mucous membrane and cartilage, helps to establish the presence of tumors and the location of metastases. The method does not provide negative impact per person, because does not use x-ray radiation and can be performed as often as desired, including to monitor the result of treatment.
It happens that sinusitis is detected in patients referred by a neurologist for an MRI of the head with suspected neurological disorders. This diagnosis is not confirmed, while the results indicate sinusitis, which could be the cause of the headaches.
What does MRI of the paranasal sinuses show?
During diagnostics, the tomograph creates a large number of photographs of the nasal area in different planes. The study allows us to identify problems with the nose such as:
- malignant neoplasms of the paranasal sinuses and nasopharynx;
- the extent of tumor spread to neighboring areas;
- benign mucosal formations: polyps, cysts;
- development of an abscess from complications chronic sinusitis;
- adenoid growths;
- developmental anomalies of the nasopharynx and paranasal sinuses;
- the degree of hypertrophic changes in the tonsils, etc.
Using Contrast
MRI of the paranasal sinuses can be performed with or without contrast. Gadolinium is widely used as a contrast agent. The substance is administered parenterally. The use of contrast is necessary if the presence of tumors of the nasopharynx and paranasal space is suspected; the introduction of a contrast agent improves the ability to accurately assess the extent of changes and their differentiation, in other cases - at the discretion of the doctor.
Contraindications to MRI with contrast:
- first trimester of pregnancy or breastfeeding;
- individual intolerance to the components of the contrast agent;
- renal failure;
