How to do an MRI of the sinuses. What does MRI diagnostics of the sinuses show? Isn’t it better to do a CT scan or MSCT? Which is better for the sinuses - MRI or CT

Due to the increase in inflammatory and malignant lesions of the ENT organs, in last years the percentage of use of such examination method as MRI of the sinuses has increased.

despite the fact that there is active debate regarding the appropriateness of use, the choice of management protocols and its advantages over CT.

However, it is difficult to overestimate the capabilities of magnetic resonance imaging, especially in comparison with x-ray diagnostic methods.

What are the sinuses: where are they located?

As is known, the nasal cavity communicates directly and forms 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 cleanse, warm and humidify the inhaled air. In addition, they participate in the formation of the voice and play the role of a shock absorber in various skull injuries.

At the same time, the sinuses often serve as entry points for various 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 maxillaries, also known as the maxillae, are located in the substance of the maxillary bone and communicate with the nasal cavity.


It is noteworthy that that the upper wall of the formation contains the canal of the inferoorbital nerve. Such a structure increases the risk of developing both intracranial and intraorbital inflammatory complications in case of damage to these sinuses.

The frontals, according to their name, are localized in the thickness of the frontal paired bones and consist of four walls.

In this case, the lower and cerebral walls can serve as a place for the spread of infection into the orbit or substance of the brain.

Children under 7-8 years old are not diagnosed with frontal sinusitis, since they have 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 importance, the upper wall of the formation is the bottom for the sella turcica, 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 is not a routine examination method, since during its passage a person experiences a certain radiation load.
Source: website Indications for the procedure:

1. Long pain syndrome localized in the sinuses (forehead, brow ridges, above upper jaw etc.), signs pathological changes on or during direct rhinoscopy.
2. Prolonged headaches of unspecified origin, frequent nosebleeds.
3. Purulent or other abnormal discharge from the nasal passages that does not fit into the picture of an acute respiratory infection or other respiratory infection.
4. Signs birth defect, injury to the nasal cavity and sinuses.
5. , sharp deterioration of vision (when more than common reasons), causeless congestion and resistant to specific treatment allergic rhinitis.
6. If you suspect sinusitis, polyposis or cysts in the sinuses, a neoplastic process.

IN in some cases Magnetic resonance imaging of this area is a step of despair (when other methods have not given any reliable results), and in some cases it is the initial diagnostic link that gives 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 MRI of the paranasal sinuses, since some pathology is better “seen” by X-ray or computed tomography.

If you make a comparison between CT and MRI, it is quite difficult to determine which is better. Each method has its own disadvantages and advantages.

At the core computed tomography lies in 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, which does not produce 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 examination plane without changing the patient’s position.

In case of injury to the facial skull, it is preferable to prescribe a CT scan, since it allows for excellent visualization of the bones.

It is also worth noting that when performing an MRI with contrast, the patient is intravenously injected with a substance that does not contain radioactive iodine, to which allergies often develop and are often 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.

The mechanism of action of magnetic resonance imaging (MRI)

The magnetic coil built into the machine and its pulsating waves read the magnetic field created by tissue containing a large number of water, and then takes a photo paranasal sinuses nose

The device itself can scan in different planes specified by the doctor, creating a multi-planar image.

In addition, the MRI machine contains a limiter that controls the release of energy into the body of the person being studied.

Preparation for MRI of the paranasal sinuses

When an MRI or other paranasal structures is prescribed, the attending physician must consult the patient about the specifics of the preparation.

First of all, you must follow safety precautions and some recommendations:

1. Remove all metal objects (earrings, rings, watches, piercings);
2. Wear loose clothing without metal inserts.
3. If you have mild claustrophobia or other mental disorders It is advisable to start taking sedatives 1-2 days before the study.
4. If the procedure involves the introduction of a contrast agent, it is advisable to refrain from eating a few hours before the start.
5. People prone to allergies are prescribed antihistamines.

Thus, there are no significant rules for preparation however, the patient should be aware of important nuances and technique.

MRI of the sinuses: how is the examination done?

After removing all unnecessary items, the patient goes to a special diagnostic room with a tomograph.

The nurse helps him lie down comfortably on the extendable table and advises him on further actions.

If an examination is scheduled for a child, then it is important to explain the procedure in a clear manner and assure him that it will not hurt at all and that the parents will be very close by.


After this, the sliding table enters completely into the scanner and the examination begins, and the nurse takes his post in a separate room with the doctors.

On at this stage it's important to lie with eyes closed and not make any movements.

While rotating, the cylindrical camera makes many slices of the human body in different planes, while creating loud and unpleasant sounds that should not be frightened.

Typically, the examination takes from 20 to 40 minutes, and the nurse notifies you when it is completed. The conclusion is issued either on the day of the procedure in a couple of hours, or you are asked to pick it up the next day.

The price for MRI of the sinuses ranges from RUB 1,600.00 to RUB 4,980.00

What does MRI of the sinuses show: interpretation

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 non-inflammatory fluid (transudate).

These formations can be single- or multi-chamber. Cysts in the maxillary sinuses on MRI (T2 mode) are visualized as hyperdense, homogeneous and round structures in the thickness of the bone.

Or related fabrics. With sinusitis, the image will show 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 already at early stages and are a round or oval formation with unclear contours.

- these are multiple benign formations consisting of lymphoid or glandular tissue on a leg. Polyps of the maxillary sinus are clearly visualized on the tomograph screen.

Anomalies of the bone structure of the nasal cavity and sinuses, injuries - cracks, fractures, etc. The description of a fracture includes: a bone defect and deformation of the sinus, displacement of bone fragments, and quite often the formation of a hematoma (hypodense round formation).

A magnetic resonance imaging scanner is one of the most modern medical devices for complex purposes; it can be used to examine almost all parts of the human body and identify the most various diseases. It is also used for magnetic tomography of the sinuses.

What are sinuses?

Before describing the features of MRI of the paranasal sinuses, it is worth understanding what sinuses are. Otherwise called sinuses, they are hollow structures constantly filled with air. Determining the location of the maxillary or nasal sinuses is very simple: they surround nasal cavity on the sides and top of the nose.

In total, there are four pairs of nasal sinuses, each of them is connected to the nasal cavity, among them: the frontal and lateral sinuses, as well as a pair of ethmoid and sphenoid sinuses. MRI of the sinuses of the last two pairs of sinuses is especially valuable, since they are located far behind the nasal cartilage and other methods for examining them are not applicable.

When is diagnosis necessary?

MRI of the paranasal sinuses is always carried out as prescribed by a doctor; he can recommend this examination to a patient with the following symptoms:

• the patient complains of frequent pain in the frontal bone;
• sick for a long time tries unsuccessfully to get rid of a runny nose;
• a person is worried about nasal congestion, difficulty breathing, the causes of which have not yet been identified;
• development was diagnosed inflammatory process in one or both nasal sinuses;
• the patient cannot cope with allergies, including.

Medical indications for the procedure:

1. The patient has frequent headaches, despite the fact that similar research methods did not reveal any abnormalities, and the cause has not yet been established.
2. The doctor suspects that the patient has developed hematosinusitis (accumulation of blood in the sinuses).
3. If a person has previously had broken nasal bones or they have an abnormal structure from birth, the person experiences difficulty breathing.
4. Fresh nasal injuries, when it is impossible to fully diagnose them without magnetic CT.
5. In the event that during a medical examination a cyst was discovered in the nasopharynx area.
6. Magnetic CT is prescribed when any tumors appear in this part of the body, especially if there is suspicion of their malignancy.

Contraindications:

1. MRI of the paranasal sinuses cannot be used on people who have metal prostheses installed in their bodies that cannot be removed during the scan.
2. Because of harmful radiation which the patient receives during the scan, the procedure is not used for girls at any stage of pregnancy.
3. It is also worth temporarily abandoning this method of examination for women who are breastfeeding.
4. A direct contraindication to the procedure is the presence of insulin pumps on the patient’s body.
5. MRI is not applicable to those who constantly use vascular clips, hearing aids, or cardiac pacemakers.

Also, special caution should be used when applying this type of diagnosis to patients who suffer from claustrophobia, that is, they are afraid of enclosed spaces. It is almost impossible to perform magnetic tomography maxillary sinuses, as well as similar scanning of any part of the body of a person who does not control the movements of his own body. During the procedure, the patient is required to remain completely still, otherwise the tomography results may be biased.

Features of the procedure

MRI of the sinuses is performed using a conventional tomograph, but using special programs that can detect any pathologies and diseases of the paranasal areas. The device looks like a closed chamber in the shape of a cylinder, the patient is placed in it in a supine position. The peculiarity of this type of examination is that due to the abundance of mucous membranes, as well as bone and cartilage tissue in this part of the face, a more thorough scan is required, otherwise it will be uninformative.

Applying Contrast

It is also worth noting that in some cases contrast is used - a liquid that is injected into the vessels and colors them, allowing them to be visualized as much as possible. Most often, this substance consists of gadolinium, so magnetic CT scanning of the sinuses with contrast has a number of additional contraindications, which your doctor will inform you about. If a scan is performed when there is a suspicion of development oncological diseases, then the use of a contrast agent becomes mandatory.

It is worth noting that the technology of computer examination using contrast of the paranasal sinuses is much more complex than without it. It requires a certain level of qualification from the diagnostician, and also lasts much longer. Before such a procedure, you should make sure that the patient is not allergic to contrast. If contrast is used, you must stop eating and drinking for at least six hours. With a conventional magnetic CT scan, no special preparation is required.

How is the examination carried out?

During scanning, the MRI machine produces multiple images of a certain area of ​​the body from different angles, a kind of slices. During the examination of the nasal area, the patient is usually in a supine position, in order to completely eliminate even the slightest movements of the patient, fixing straps for the limbs are used. If a person cannot control his movements, he is offered to take sedatives.

The scan lasts no more than 10 minutes, if it is done without contrast, the patient will not feel any pain or discomfort. The tomograph itself makes a faint crackling sound when scanning; this should not frighten the patient. Note that during the procedure, the patient is completely alone in the office, and the doctor observes the process from the next room, watching the images on the monitor screen. Immediately after the scan, the patient is sent home and can return to normal activities immediately.

MRI of the sinuses is not a cheap procedure, its price may vary depending on the region and pricing policy medical institution where it is carried out. Usually its cost varies between three and five thousand rubles.

Decoding the research results

After the scan, the doctor prepares a transcript of the study results, which will indicate the presence or absence of pathologies. We can talk about positive examination results if all the structures in this area have a normal structure. MRI helps to identify the following diseases of the maxillary sinuses and adjacent areas:

1. Any, including cancerous tumors.
2. – infection bone tissue.
3. Inflammatory processes of soft tissues of the nasopharynx.
4. Polyps and cystic formations in the nose.
5. , sinusitis, .
6. Any chronic diseases in this area.
7. Various structural defects and developmental anomalies.
8. Various types of injuries to this part of the face.

An examination of the sinuses is prescribed by an ENT specialist. First, he examines the passages and 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 perform a rhinoscopy. If pathological processes are detected, their location should be clarified. For this, an MRI of the nose is performed. X-rays or CT scans are also often used, however, these techniques help to identify sinusitis and sinusitis, but are of little information in monitoring 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's body. He is not exposed to additional radiation. Also, MRI of the sinuses, the price of which is much lower than for examination of other areas, is a highly informative and visual method. The method allows for a comprehensive diagnosis of soft tissues; inflammatory processes, mucosal tumors and polyps are clearly visible in the images.

Innovative research using magnetic resonance imaging reveals most of the known medical science diseases. MRI of the nose and paranasal sinuses is a fairly common study in the diagnosis of ENT pathologies and provides maximum information about the condition of specific anatomical areas for the attending physician.

Anatomy of the sinuses

The sinuses in the facial part of the human skull are cavities filled with air, surrounding the nasal passages on almost all sides. Four pairs of these anatomical structures are connected to the nasal cavity by separate passages, which become conductors for the spread of infection and diseases of other nature. The paired wedge-shaped cavity is located at the most pronounced distance from the nose, and only magnetic tomography makes it possible to identify the pathological process in it.

When to do an MRI

The newest computer test requires strict indications for use, which every doctor takes into account. Indications for research usually include the following points:

1. Intense pain syndrome is most pronounced in the forehead area (according to the patient) - characteristic.
2. Chronic runny nose has a protracted course, relapses occur rarely and for a short period of time.
3. and difficulty breathing for a long time cannot be identified and treated in accordance with the etiological factor.
4. Infectious or allergic cause sinusitis is established, but treatment does not bring the expected effect, and the process spreads to other sinuses.
5. Traumatic lesions of the nose and sinuses are a separate indication for an MRI procedure. Fresh organ damage is sometimes impossible to determine and determine the scope of therapeutic or surgical care.
6. MRI of the paranasal sinuses is indicated for accumulation of blood in the organs in the absence of an established cause, as well as for suspected malignant tumor process in the sinuses.

The procedure allows us to differentiate many diagnoses and establish primary cause pathology.

Features of the study

To carry out a magnetic resonance procedure, specific equipment is required in the form of a topographer on which the examination program is installed. The patient is placed on a horizontal surface, which is connected to a closed cylindrical chamber. The device produces multiple images of the specified area with high frequency and at different angles, which creates a holistic projection of the anatomical zone.

MRI of the paranasal sinuses is somewhat technologically complex. The scanning here is performed with special care, since a large number of mucous membranes, small bones and cartilage complicates the general visualization of organs and the characteristics of their condition.

• Magnetic tomography can reliably show all the physiological aspects of each organ only if the person does not move. To securely secure the patient, fabric belts are used to avoid even the slightest movements. If minor convulsions occur in this condition, therapy is indicated sedatives in moderate doses.
• The total duration of the procedure usually does not exceed 10 minutes - this is quite enough to confirm or exclude sinusitis.
• Research does not bring painful sensations, does not cause hemodynamic or respiratory disorders.
• The patient may hear some audio during the scan, but this should not be alarming.
• The potential patient is alone in the research room; the medical team watches him through a screen in the next room, while assessing the revealed structure of an organ or anatomical zone.

After the patient finds out what the MRI of the maxillary sinuses showed, he returns to his usual lifestyle. If a pathology is detected, it is prescribed conservative treatment or the patient is admitted to hospital.

Interpretation of results

The doctor can evaluate the MRI of the paranasal sinuses on the spot, but he will definitely carry out a detailed interpretation of the images later. Positive result is the absence of pathological processes and formations in the area under study, while the structure of the sinuses corresponds to the anatomical and physiological parameters.

The study is informative for a number of diseases and disorders:

1. Tumor processes in the sinuses, even in the early stages of development.
2. Osteomyelitis of bone structures of the anatomical region.
3. Foci of the inflammatory process directly in the sinuses or adjacent areas.
4. Polyp growths, cysts in the sinuses.
5. Congenital and traumatic violations of the integrity of organs and structural anomalies.

MRI allows you to resolve complex clinical situations with nonspecific symptoms and concomitant pathologies. Examination of the nasal sinuses directly reveals the etiology:

• difficulty breathing;
• increased mucus from the nose;
• itching;
• burning;
• other unpleasant sensations in the nose.

A correct diagnosis allows you to prescribe etiotropic treatment and formulate an optimistic prognosis for recovery and absence of relapses.

MRI contraindications

The pathological process shown on MRI is easier to recognize and, as a result, treat. However, it should be noted that the procedure has some contraindications for use:

1. Magnetic resonance imaging is not recommended for persons whose body contains metal plates or prostheses that are firmly fixed and are not removed during the procedure.
2. The study is not carried out for women at any stage of gestation, as well as for nursing mothers.
3. Various invasively installed devices also do not allow the examination. This paragraph applies to innovative insulin pumps, pacemakers, vascular clips and hearing aids.
4. Patients with a fear of closed spaces will also find it difficult to carry out the procedure.

For all other groups of patients, tomography is performed successfully with high efficiency.

Experts call the sinuses the special cavities between the bony structures of the skull, lined with mucous membrane on the inside and designed to warm and humidify the air inhaled through the nose, as well as to form the voice. If you have problems with this part of the respiratory system, you should first contact an otolaryngologist, who will first examine the nasopharynx and rhinoscopy (smear) of the paranasal sinuses, and, if necessary, refer the patient for an MRI of the sinuses.

Cases in which tomography is indicated

The structure of the paranasal space is a complex of 4 pairs of sinuses - frontal, sphenoid, maxillary (the so-called maxillary) and a pair of ethmoidal labyrinths. This complex system operates smoothly and clearly in a healthy state, however, there are times when the nasal sinuses begin to pathological processes, which cannot be identified by inspection and analysis of mucous membrane secretions. Clarifying the exact location of these anomalies and pathologies, assessing their size and the degree of danger to the patient’s health is one of the indications for the use of magnetic resonance imaging.
Other indications for sinus MRI may include:

• need for confirmation allergic reactions affecting the upper respiratory tract;
• identifying the presence of cysts and various tumors;
• assessment of anatomical disorders of the skull structure in the area of ​​the paranasal sinuses;
• diagnostic test inflammatory diseases in the paranasal sinuses;
• detection of polyps.

Symptomatic indications for tomography of the nasal sinuses are the following:

• headaches, the origin of which has not been identified;
• noise in ears;
• discomfort when swallowing;
• loss of smell;
• nasal discharge, including nosebleeds.

Headaches in the forehead and paranasal area always receive significant attention from specialists, since such symptoms may signal a problem with the brain.

Diseases detected by diagnostics

Most cases of contacting an otolaryngologist with complaints about the respiratory system end with a diagnosis of the most common ailment - sinusitis. To detect it, a simple x-ray is sufficient, although many other diseases with similar symptoms can be detected exclusively using MRI of the sinuses. These problems include:

• infectious processes affecting mucous membranes;
• inflammation of the maxillofacial joints, soft tissues, adnexal cavities;
• tumor formations with recurrent metastasis;
• cerebral hernia (damage to the roof of the ethmoid bone);
• consequences of sinus injuries.

Like magnetic resonance imaging of other organs and systems of the human body, diagnostics of the sinuses is deservedly popular in preparation for surgical intervention in the area of ​​the respiratory organs and the adjacent area of ​​the brain. This procedure is important in postoperative period, as it allows you to monitor the result of the operation and determine how effectively the treatment is going.

The MRI procedure of the sinuses is indispensable in cases where it is impossible by other means to examine the extent to which polyps, abscesses, and neoplasms have spread to neighboring tissues and organs. Due to the fact that in the paranasal sinuses there is a lot blood vessels, tomography images of this area come out as clear and detailed as possible, which makes this method the best.

Advantages of the method

Although MRI of the paranasal sinuses reveals any changes in the healthy structure of the mucous membrane and soft tissues of the nose and paranasal sinuses, the most common target of the study is primary and secondary formations of any type. MRI images allow you to see tumor formations of a benign and malignant nature, the localization of metastases, as well as their penetration in later stages of oncology into nearby tissues and organs.

Examination of the nasal sinuses using magnetic resonance imaging is carried out quite quickly - the whole procedure takes 25 minutes, along with waiting for the injected contrast to take effect (a substance based on gadolinium salts, which tends to spread through the circulatory system, settling in tissues/organs affected by tumor cells, highlighting them on MRI images). This is due to the fact that to diagnose a given area, it is not necessary to capture a large area, so everything is examined in one “pass” of the scanner.

Another advantage diagnostic method Magnetic resonance imaging is that such a study can be carried out as an addition to computed tomography. Using MRI, the paranasal sinuses are examined soft fabrics, mucous membranes and circulatory system, CT scan shows the integrity of bone structures, the presence of tumors growing from the paranasal sinuses with nearby tissues into the bone structure.

Price for MRI of sinuses

MRI examination of the nasal sinuses is carried out quickly, is studied in detail, and is not at all expensive. In most medical institutions in Russia, providing such a service costs from 2,500-3,000 (without contrast) to 5,000-5,500 rubles (with the introduction of a contrast agent). The average cost of a nose scan is 4,800-7,000 rubles (depending on the region). The price minimum is fixed in Tula - 4,000 rubles per full complex services, the maximum, of course, in Moscow is up to 15,000 rubles (tomography with contrast).
Even the most harmless runny nose can become the beginning of a complex inflammatory process, the consequences of which will haunt the patient for the rest of his life. If we talk about such an ailment as sinusitis, its untimely detection can lead to even more dangerous consequences– penetration of infection into the brain, formation of purulent foci, inflammation of the meninges.

By visiting a doctor in a timely manner and undergoing an MRI, these and many other troubles can be avoided.