The area of the head that is least exposed to magnetic resonance imaging is the region of the sinuses. Around the nose there are several hollow zones covered with ciliated epithelium - a mucous structure with a certain bactericidal effect. These cavities are connected to the nasal cavity by special passages and are normally filled with ordinary air. The purpose of the cavities is still not very clear. There are a number of hypotheses that explain some of the functions of these formations, but it was not possible to fully elucidate their purpose.
Sphenoid cavity, maxillary (maxillary), frontal sinuses and the ethmoid labyrinth make up a rather complex paranasal space. Impact of this zone on activities respiratory tract and pericerebral space has not yet been studied in detail. But diseases localized in the sinuses lead to very unpleasant pain and the general non-working state of the body.
Diagnostics of the nasal cavities
MRI paranasal sinuses the nose is not considered the main method of diagnosing this area. The presence of many bone formations in the human skull determines the demand for diagnostics, which can more effectively visualize changes in the structure of the skull. These studies primarily include X-ray methods - CT scan and radiography.But inflammatory conditions and tumors of various etiologies are easier to see with MRI of the paranasal sinuses. MRI of the paranasal sinuses and nasopharynx is very effective if it is necessary to examine the orifices of the ducts between the nasopharynx and sinuses. MRI is used when detecting:
- allergic reactions to external irritants
- suspected sinus cyst or tumor
- structural features of the paranasal sinuses of an abnormal nature
Also an indication for magnetic resonance imaging of the paranasal sinuses are headaches of uncertain origin, especially concentrated in the frontal part of the head, frontal and paranasal areas. Sometimes pathologies that can be detected by computed tomography of the frontal sinuses appear unpleasant sensations swallowing and tinnitus.
Features of the MRI of the paranasal space
MRI of the paranasal sinuses is performed on a conventional tomograph using special programs that are aimed at detecting pathologies in the structure and functioning of the paranasal space. The abundance of mucous structures, bone and cartilage tissues requires a very thorough study of this area.If oncological processes are suspected, MRI of the sinuses is performed using contrast agents.
The technology of conducting magnetic resonance imaging of the paranasal sinuses using contrast agents is more complex and time-consuming than conventional tomography. A contrast agent is injected into a vein for some time, and the study itself lasts about half an hour. Before the procedure, it is necessary to conduct research on the absence of allergic reactions.
Magnetic resonance imaging is a closed cylindrical chamber in which the patient is placed in a supine position. The chamber is closed on both sides, and people with bright severe symptom claustrophobia, you can do an MRI of the sinuses only in the state medication sleep or abandon this type of diagnosis in favor of CT or ultrasound.
Also, MRI of the paranasal sinuses is not recommended for people who have built-in electronic devices such as pacemakers or insulin pumps in their bodies. Metal implants, fragments or prostheses are also a serious obstacle to the production of this procedure.
Diagnosis of sinuses in children
A separate topic is the MRI of the sinuses of the child. Features of the physical principles of the operation of a magnetic tomograph do not put forward any obstacles to MRI of the sinuses in children. This procedure is completely painless and safe. The tomograph does not have any radiation effect on the body. All interaction of the magnetic field of the tomograph and the organism of the subject is carried out at the atomic level without the slightest impact on the general subject. When the tomograph is turned off, all body systems return to their previous indicators without the presence of minimal residual effects.What to choose - CT or MRI?
If an alternative arises, to perform an MRI or CT scan of the paranasal sinuses, then you can choose according to three criteria - information content, safety and cost. In terms of information content, MRI and CT are approximately on the same level. It is possible to identify pathologies of the structure, mucous membranes, the presence of tumors and metastases, various inflammatory conditions. In terms of safety, MRI is an order of magnitude higher than CT. The magnetic field does not have any radiation or ionizing effect on the human body.The cost of CT and MRI differ significantly. Therefore, magnetic resonance studies should be performed only in the presence of very serious indications.
An examination of the sinuses appoints an ENT. Previously, he examines the passages, examines the tissues of the skull for integrity. To identify the nature of the contents of the sinuses, it is necessary to take a smear, that is, to conduct a rhinoscopy. Upon detection pathological processes their location should be specified. For this, an MRI of the nose is performed. X-rays or CT scans are also often used, but these techniques help to identify sinusitis and sinusitis, but are of little information in tracking the effectiveness of treatment and detecting relapses.
MRI of the sinuses: price
A significant advantage of the magnetic resonance method over x-ray examination becomes safe for the patient. It is not exposed to additional radiation. Also, MRI of the sinuses, the price of which is much lower than for examining other areas, is a highly informative and visual method. The method allows for a comprehensive diagnosis of soft tissues, the images are clearly visible inflammatory processes, mucosal tumors and polyps.
In connection with the growth of inflammatory and malignant lesions of the ENT organs, in last years the percentage of use of such a method of examination as MRI of the sinuses has increased.
despite the fact that there are active disputes regarding the appropriateness of use, the choice of protocols for maintaining and its advantages over CT.
However, it is difficult to overestimate the possibilities of magnetic resonance imaging, especially in comparison with X-ray diagnostic methods.
What are the sinuses and where are they located?
As is known, nasal cavity communicates directly and constitutes a single functional system with paranasal sinuses. They are depressions (or cavities) in the main and facial parts of the skull, lined from the inside with an epithelial membrane.Their function is to purify, warm and humidify the inhaled air. In addition, they are involved in the formation of the voice and play the role of a shock absorber in various injuries of the skull.
At the same time, the sinuses often serve as entry gates for various kinds of pathogenic microorganisms, pus and atypical cells, which subsequently easily spread to other structures of the skull and brain.
In adults, there are four types of paranasal sinuses:
- maxillary (are paired);
- two frontal;
- main;
- lattice.
The maxillary, their still, are located in the substance of the maxillary bone and communicate with the nasal cavity. 
Remarkably, that the upper wall of the formation has a canal of the infraorbital nerve. Such a structure increases the risk of developing both intracranial and intraorbital inflammatory complications in case of damage to these sinuses.
Frontal, according to their name, are localized in the thickness of the frontal paired bones and consist of four walls.
At the same time, the lower and brain walls can serve as a place for the spread of infection into the orbit or brain substance.
Children under 7-8 years old are not diagnosed with frontal sinusitis, since their frontal sinuses are still undeveloped and almost completely closed.
The location of the main sinus is the body sphenoid bone located behind the lattice labyrinth.
Of the important, the upper wall of the formation is the bottom for the Turkish saddle, on which the pituitary gland (an organ of neuroendocrine regulation), the optic chiasm and the olfactory pathways “sit”.
The ethmoid labyrinth is located in the bone of the same name and carries a large clinical significance due to the fact that it has a connection with many channels of the facial part of the skull.
Indications for the procedure: grounds for such a diagnosis
MRI of the nose and paranasal sinuses does not belong to the routine examination methods, since during its passage a person experiences a certain load of radiation.
Source: site Indications for the procedure:
- Long pain syndrome with localization in the sinus region (forehead, superciliary arches, above the upper jaw, etc.), signs pathological changes on or during direct rhinoscopy.
- Prolonged headaches of unspecified origin, frequent nosebleeds.
- Purulent or other abnormal discharge from their nasal passages that do not fit into the picture of acute respiratory infections or other respiratory infections.
- signs birth defect, trauma to the nasal cavity and its sinuses.
- , a sharp deterioration in vision (when more than common causes), causeless congestion and resistant to specific treatment allergic rhinitis.
- If you suspect sinusitis, polyposis or cysts in the sinuses, neoplastic process.
AT individual cases magnetic resonance imaging of this area is a step of desperation (when other methods have given any reliable results), and in some - the initial diagnostic link, giving a complete picture of the disease. 
Advantages and disadvantages of the MRI procedure: when is a CT scan needed?
It is not always necessary to blindly prescribe an MRI of the paranasal sinuses, since some pathology is better seen by x-rays or computed tomography.
If we compare between CT and MRI, it is quite difficult to determine which is better. Each method has its own disadvantages and advantages.
Computed tomography is based on the use of x-rays emitted from a special x-ray tube that rotates around the human body. 
Thus, during the study, the patient receives radiation, while MRI uses a magnetic field that does not give any adverse reactions.
In addition, as a result of magnetic tomography, a more detailed image of soft tissues is obtained, and the device itself is able to change the image contrast and the examination plane without changing the position of the patient.
When traumatizing the facial skull, it is preferable to prescribe a CT scan, since it perfectly visualizes the bones.
It is also worth noting that during MRI with contrast, the patient is intravenously injected with a substance that does not contain radioactive iodine, to which allergies often develop and are not rarely used in computed tomography.
The advantages of the X-ray method include the speed of the procedure (about 5-7 minutes), the absence of contraindications in the presence of metal objects in the body (pacemakers, etc.) and the cost - CT is cheaper.
Mechanism of action of magnetic resonance imaging (MRI)
The machine's built-in magnetic coil and its pulsating waves sense the magnetic field generated by tissues containing a large number of water, after which he takes a picture of the paranasal sinuses.
The device itself can perform scanning in different planes specified by the doctor, thus creating a multi-plane image.
In addition, the MRI machine contains a limiter that controls the release of energy into the body of the person being examined. 
Preparation for an MRI of the paranasal sinuses
When an MRI or other paranasal structures is prescribed, the attending physician will necessarily advise the patient on the specifics of the preparation.
First of all, it is necessary to observe safety precautions and some recommendations:
- Remove all metal objects from yourself (earrings, rings, watches, piercings);
- Wear loose clothing without metal inserts.
- If you have a mild degree of claustrophobia or other mental disorders it is advisable to start taking sedatives 1-2 days before the study.
- If the procedure will take place with the introduction of a contrast agent, then it is advisable to refuse to eat a few hours before the start.
- People prone to allergies are prescribed antihistamines.
In this way, there are no essential rules for preparation However, the patient must be aware of important nuances and technique of implementation.
MRI of the nasal sinuses: how is the examination done?
After removing all unnecessary items from himself, the patient goes to a special diagnostic room with a tomograph.
The nurse helps him lie down comfortably on the sliding table and advises him on what to do next.
If an examination is scheduled for a child, then it is important for him to explain the course of the procedure in an accessible way and assure him that it does not hurt at all and that the parents will be very close. 
After that, the retractable table fully enters the scanner and the examination begins, and the nurse takes her post in a separate room along with the doctors.
On the this stage it is important to lie with eyes closed and not make any movement.
Rotating, the cylinder chamber makes many sections of the human body in different planes, while creating loud and unpleasant sounds that should not be frightened.
Usually, the examination takes from 20 to 40 minutes, and the nurse announces its completion. The conclusion is issued either on the day of the procedure after a couple of hours, or they are asked to pick it up the next day.
The price for an MRI of the sinuses is from 1,600.00 ₽ to 4,980.00 ₽
What does an MRI of the sinuses show: decoding
Many people wonder whether the study will show sinusitis or a tumor. Therefore, consider the pathology visible using magnetic resonance imaging:
One of the sinuses, which may contain pus or any other exudate, or be filled with a non-inflammatory fluid (transudate).
These formations are single- and multi-chamber. Cysts in the maxillary sinuses on MRI (in T2 mode) are visualized as hyperdense homogeneous and rounded structures in the thickness of the bone.
Or adjacent tissues. With sinusitis, the picture will show a heterogeneous thickening of the wall of the maxillary sinus (or both), sometimes with a level of fluid, which is often represented by pus.
neoplastic processes. On MRI, tumors are usually differentiated by early stages and represent the formation of a round or oval shape with fuzzy contours.
- These are multiple benign formations consisting of lymphoid or glandular tissue on the leg. Polyps of the maxillary sinus are well visualized on the tomograph screen.
Anomalies of the bone structure of the nasal cavity and sinuses, injuries - cracks, fractures, etc. The description of the fracture includes: bone defect and sinus deformity, displacement of bone fragments, and also quite often - the formation of a hematoma (hypodense round formation).
Magnetic resonance imaging is used to diagnose various diseases. It is carried out to study the head, organs chest, joints, abdominal cavity and small pelvis. Also, this procedure is in demand for examination of the paranasal sinuses. Assigns a tomography of the head and nasal sinuses of the ENT, if the patient complains of nasal congestion, which is accompanied by headache, toothache, and discharge from the ears. Consider what are the indications for MRI of the nasal (maxillary) sinuses, and alternatives to magnetic resonance imaging - CT, MSCT.
When is MRI of the sinuses indicated?
Magnetic resonance imaging of the sinuses (the so-called nasal sinuses) is used for inflammatory diseases of the ENT organs, as well as for suspected tumors in this area. The sinuses are hollow chambers in the skull filled with air and connected to the nasal cavity. In total, there are three types of paired sinuses:
- frontal - located above the nose in the frontal bone;
- lattice labyrinth;
- upper jaw(maxillary) - the two largest.
There is also an unpaired sphenoid sinus, located in the bone of the same name. Until now, doctors have no consensus on what the main functions of these parts of the skull are. Some believe that the sinuses are designed to lighten the weight of the skull, others attribute to them the properties of a buffer that protects the brain upon impact.
MRI of the sinuses is indicated for suspected conditions such as:
Also, MRI will help the doctor to identify the location of the cyst and its size, to find the cause of the headache, which is not diagnosed by other methods. In addition, MRI is often prescribed after nasal injuries in order to most accurately determine internal damage nasopharynx.
Contraindications to the procedure
MRI of the head and sinuses has contraindications. Tomography is not prescribed for people with implants in the skull, metal fixed dentures. It is not allowed to do the procedure for patients with heart pacemakers, vascular clips, women in the first trimester of pregnancy. At the same time, the harmful effect of the magnetic field on the fetus has not yet been proven, and this limitation is only reinsurance.
If the device is used closed type, for people suffering from bouts of claustrophobia, such a study will be quite difficult to survive. If the patient has epileptic seizures, this should be notified to the doctor before the session.
Stages of MRI diagnostics of the nasal sinuses
To pass the study on the MRI machine, the patient is placed on the couch, which subsequently makes translational movements back and forth. The head is fixed with a special hoop - this must be done so that the person remains completely immobile. After the preparatory measures, the medical staff retires to the observation room and turns on the MRI machine.
The device creates a magnetic field, and a ring with sensors rotates around the subject's head, which transmit data to a computer. The picture is displayed on the doctor's monitor; during the examination, he can change the shooting angle when he wants to examine the area of interest in different projections - two or three. If discomfort occurs during the session, you can give a signal - press a special button on the remote control, which is in the hands of the patient.
If necessary, the doctor prescribes an MRI with contrast. This type of procedure involves the introduction of a special substance that helps to see not only pathological formations, but also their structure, size, location. Contrast can cause allergies, and its use is contraindicated in people with renal or hepatic insufficiency.
What does a tomogram show?
MRI of the paranasal sinuses is a fairly informative study. PPN tomography can show:
Radiation doses in the study
During the study in the MRI machine, the patient is not irradiated. This equipment uses the properties of a magnetic field that causes hydrogen protons to behave in a special way. They line up along the lines force field, then these particles are excited by a radio pulse. Protons after the forced movement return to their places in a state of rest, that is, "relax". At this moment, a certain amount of energy is released, which is recorded by the reader. These data become the basis for creating a layered image of organs.
Computed tomography and MSCT (multispiral computed tomography) is another way to obtain information about the condition of the sinuses and nasopharynx. This study gives a radiation load on the body. AT different sources a different safe dose of radiation for a person per year is indicated: on average it is 4 mSv. Sievert is a unit of measure of radiation that biological tissue can absorb. During an x-ray of the head (including the sinuses), the patient receives a dose of radiation up to 0.02 mSv. In the study of CT and MSCT of the sinuses, this dose can reach 2 mSv, since the number of images can be very significant.
Which method of examination of the sinuses is better - MRI, CT or MSCT?
It is impossible to answer the question which of the methods (MR-tomography, CT or MSCT) is more suitable for the study of the paranasal sinuses. Each of them has its own purpose and is preferred for diagnosing a number of diseases.
Consider the features different kind tomographs:
- To detect tumors, it is better to use MRI, since this method well shows the condition of soft tissues. At the same time, MRI is contraindicated in patients who have implanted metal elements - endoprostheses, pacemakers, etc.
- The MSCT and CT equipment is not so sensitive to the movements of the patient, and magnetic resonance imaging requires a long-term immobility of the patient, which is not always possible to provide.
- MSCT of the paranasal sinuses is considered to be a more advanced study than CT. Theoretically, both of these procedures can cause the development oncological diseases, as they give a radiation load to the body, while MRI is almost completely safe.
Based on the above features, it is worth choosing a research method (MSCT or MRI) based on individual testimony and contraindications. It is better to choose a procedure together with your doctor.
MRI of the sinuses- this is informative method examination of bone cavities communicating with the nasal cavity, which is absolutely safe for the patient.
MR imaging allows you to visualize (obtain images) not only bone structures, but also soft tissues and sinus contents, if any.
What does an MRI of the sinuses show?
The following pathological changes can be found on the pictures:
- anomalies in the structure of the facial part of the skull;
- changes in bone structures: tumor germination, trauma, cyst;
- changes in the mucous membranes: polyps, inflammation, swelling, thickening;
- the presence of contents in the sinuses: foreign bodies, liquid, tumor.
Practice shows that the findings of doctors can be the most unexpected. For example, in maxillary sinus maxillary teeth may be found that have "mixed up" the direction of growth. Such a finding can simultaneously explain the absence of teeth in the upper jaw in oral cavity and persistent pain in the sinus area varying degrees intensity.
The resulting images are layered sections of tissue with a thickness of several millimeters to 1 centimeter. The slice thickness is set manually in the device settings. Sections can be made in any plane. Also, modern devices make it possible to obtain a three-dimensional model of the anatomical formations of the study area.
Indications for MRI of the sinuses and nasopharynx
Magnetic resonance imaging of the sinuses is performed infrequently, just like MRI of the lungs, since in most cases the possibilities of radiography are enough to diagnose the most common pathology and make a diagnosis. Testing is rarely ordered for uncomplicated sinusitis or sinusitis.
You can get a referral from a doctor for an MRI of the sinuses in the following cases:
- frequent headaches, the cause of which is not established;
- toothache or pain in the cheekbone area, when dentists do not find pathology of the teeth and gums;
- chronic inflammatory diseases upper respiratory tract with frequent relapses and ear complications;
- stuffy ears, the cause of which cannot be identified in other ways;
- suspicion of a cerebrospinal fluid fistula (a small opening through which the cranial cavity connects to the nasal cavity and through which cerebrospinal fluid constantly flows);
- allergic rhinitis, fungal sinusitis;
- suspicion of a tumor in the sinuses of the nose;
- determination of the stage and prevalence of a malignant neoplasm;
- differential diagnosis of hemorrhage in nasal sinus(hemosinusitis) and purulent sinusitis.
Contraindications for MRI of the nose and paranasal sinuses
The study is not carried out in the following cases:
- in the patient's body there are foreign bodies made of metal: piercing, which the patient refuses to remove, braces, pins, plates, metal vascular clips, etc.;
- implanted pacemaker and others electronic devices which may be damaged magnetic field.
There are also a number of contraindications for MR imaging with contrast enhancement.:
- pregnancy;
- breast-feeding;
- chronic renal failure.
Preparation for the procedure
Special preparation for the procedure is not required. The following situations may be an exception:
- the introduction of contrast is planned: it is better to refuse to eat for 6-8 hours before the study in order to reduce the risk of vomiting, which can be provoked by the introduction of a contrast agent into the blood;
- there is a fear of closed space: a day or two before the procedure, it will be necessary to start taking sedatives;
- had kidney problems in the past: a few days before an MRI with contrast, a urine test should be done and biochemical analysis blood in order to exclude the presence of chronic renal failure.
How is an MRI of the paranasal sinuses performed?
The procedure itself is painless and does not cause any concern to the patient. Uncomfortable may be unless the need to remain motionless for a long time.
Before going to the MRI room, you must remove all metal jewelry and any clothing with metal fasteners. Usually, the medical staff offers to change into a special gown or a spacious shirt, in which it will be comfortable to lie down during the study. Also, do not bring a brother with a phone, tablet or e-book, as these gadgets can be irreversibly damaged by the device's powerful magnetic field.
For an MRI of the sinuses, the patient is placed on a retractable table of the tomograph, in the supine position. The table slides into the apparatus. Clicking or humming may be heard during operation of the machine. This is fine. It will take about 20-30 minutes to stay in the apparatus.
When the examination is completed, the table is pulled out of the scanner and the patient is allowed to get up and go to change.
Deciphering the results
Immediately after the study, you can only get pictures. It will take another 1 to 3 hours for the doctor to decipher the data received. If you don’t want to wait so long, you can get pictures and a doctor’s opinion by e-mail.
How often can you get tested
The answer to this question is unequivocal: as often as necessary. The fact is that magnetic resonance imaging does not use x-rays or other harmful effects on the body, so the examination is completely safe even with multiple repetitions.
Cost of the procedure
