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Imaging of Paranasal Sinuses, An Issue of Neuroimaging Clinics 25-4, E-Book

Imaging of Paranasal Sinuses, An Issue of Neuroimaging Clinics 25-4, E-Book

Varsha M. Joshi

(2016)

Additional Information

Abstract

Imaging of Paranasal Sinuses is explored in this important Neuroimaging Clinics issue. Articles include: Current trends in sinonasal imaging; Normal anatomy and anatomic variants of the paranasal sinuses on CT; Pre-treatment imaging in inflammatory sinonasal disease; The role of CT and MRI in imaging of fungal sinusitis; Imaging approach to sinonasal tumors; The role of CT and MRI in imaging of sino-nasal tumors; The role of CT and MRI in the skull base in evaluation of sino-nasal disease; Post-treatment imaging of the paranasal sinuses following endoscopic sinus surgery; Post-treatment imaging of the paranasal sinuses following treatment for sinonasal neoplasia; and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Imaging of Paranasal Sinuses\r i
Copyright\r ii
PROGRAM OBJECTIVE iii
TARGET AUDIENCE iii
LEARNING OBJECTIVES iii
ACCREDITATION iii
DISCLOSURE OF CONFLICTS OF INTEREST iii
UNAPPROVED/OFF-LABEL USE DISCLOSURE iii
TO ENROLL iii
METHOD OF PARTICIPATION iii
CME INQUIRIES/SPECIAL NEEDS iii
NEUROIMAGING CLINICS OF NORTH AMERICA\r iv
FORTHCOMING ISSUES iv
February 2016 iv
May 2016 iv
August 2016 iv
RECENT ISSUES iv
August 2015 iv
May 2015 iv
February 2015 iv
Contributors v
CONSULTING EDITOR v
EDITOR v
AUTHORS v
Contents vii
Foreword: Imaging of Paranasal Sinuses\r vii
Preface: Paranasal Sinuses—Decongested!\r vii
Current Trends in Sinonasal Imaging\r vii
Normal Anatomy and Anatomic Variants of the Paranasal Sinuses on Computed Tomography\r vii
Imaging in Sinonasal Inflammatory Disease\r vii
Fungal Sinusitis\r viii
Imaging Approach to Sinonasal Neoplasms\r viii
Sinonasal Tumors: Computed Tomography and MR Imaging Features\x0B viii
The Skull Base in the Evaluation of Sinonasal Disease: Role of Computed Tomography and MR Imaging\r viii
Posttreatment Imaging of the Paranasal Sinuses Following Endoscopic Sinus Surgery\r viii
Post-treatment Evaluation of Paranasal Sinuses After Treatment of Sinonasal Neoplasms\r ix
Foreword: Imaging of \rParanasal Sinuses xi
Preface: Paranasal \rSinuses—Decongested! xiii
Current Trends in Sinonasal Imaging 507
Key points 507
INTRODUCTION 507
OVERVIEW OF MODALITIES USED IN MODERN SINUS IMAGING 508
Computed Tomography 508
DOSE-REDUCTION STRATEGIES IN SINUS COMPUTED TOMOGRAPHY 510
Cone Beam Computed Tomography 514
MR Imaging 516
INDICATIONS FOR IMAGING OF THE PARANASAL SINUSES AND SKULL BASE 519
IMAGE-GUIDED ENDOSCOPIC SINUS SURGERY 521
FUTURE DIRECTIONS 522
REFERENCES 522
Normal Anatomy and Anatomic Variants of the Paranasal Sinuses on Computed Tomography 527
Key points 527
INTRODUCTION 527
IMAGING TECHNIQUES AND PROTOCOL 528
EMBRYOLOGY 528
ANATOMY OVERVIEW OF THE SINONASAL REGION 528
The Nose and Nasal Cavities 530
The Nasal Cycle 531
THE NASAL SEPTUM 531
THE MIDDLE TURBINATE 532
LAMELLAR ANATOMY 532
THE UNCINATE PROCESS 532
THE MAXILLARY SINUS AND OSTIOMEATAL COMPLEX 534
THE FRONTAL SINUS AND FRONTAL SINUS DRAINAGE PATHWAY 536
THE LAMINA PAPYRACEA AND ANTERIOR ETHMOIDAL ARTERY 540
THE ANTERIOR SKULL BASE: OLFACTORY FOSSA AND HEIGHT OF THE ETHMOID SKULL BASE 541
The Olfactory Fossa 541
Height of the Ethmoid Skull Base 542
THE POSTERIOR SINUS GROUP: POSTERIOR ETHMOID SINUS AND SPHENOID SINUS 544
The Posterior Ethmoid Sinus 544
The Sphenoid Sinus 546
SUMMARY 546
SUPPLEMENTARY DATA 546
REFERENCES 546
Imaging in Sinonasal Inflammatory Disease 549
Key points 549
INTRODUCTION 549
MUCOCILIARY CLEARANCE AND PATHOPHYSIOLOGY OF SINUSITIS 549
INDICATIONS FOR IMAGING 550
IMAGING OPTIONS AND PROTOCOLS 550
IMAGING APPEARANCES 550
Acute Sinusitis 550
Chronic Sinusitis 551
Mucosal thickening 551
Bone changes 552
Secretions and opacification 552
Calcifications 553
Sequelae or Local Complications with Chronic Sinusitis 553
Retention cyst 553
Polyp 554
Mucocele 554
Staging of Chronic Rhinosinusitis 556
Complications of Sinusitis 556
Patterns of Sinonasal Inflammatory Disease 557
Pattern 1: infundibular pattern 557
Pattern II: osteomeatal unit pattern 558
Pattern III: spheno-ethmoid recess pattern 559
Pattern IV: sinonasal polyposis 559
Pattern V: sporadic pattern 560
Silent Sinus Syndrome 560
Atrophic Rhinosinusitis 560
SINONASAL INFLAMMATION IN SYSTEMIC DISEASES 560
DIFFERENTIAL DIAGNOSIS 562
PEARLS AND PITFALLS 564
WHAT THE REFERRING CLINICIAN WANTS TO KNOW: PREPARING A CLINICALLY RELEVANT REPORT 564
SUMMARY 565
REFERENCES 566
Fungal Sinusitis 569
Key points 569
INTRODUCTION 569
CLASSIFICATION OF FUNGAL SINUSITIS 569
GENERAL IMAGING CONSIDERATIONS 570
NONINVASIVE FUNGAL SINUSITIS 570
Allergic Fungal Sinusitis 570
Imaging features 570
Treatment 571
Fungus Ball 571
Clinical diagnosis 571
Imaging features 571
Treatment and prognosis 572
INVASIVE FUNGAL SINUSITIS 572
Acute Invasive Fungal Sinusitis 572
Clinical features 572
Imaging features 572
Treatment 573
Chronic Invasive Fungal Sinusitis 573
Clinical diagnosis 573
Imaging Approach to Sinonasal Neoplasms 577
Key points 577
INTRODUCTION 577
COMPUTED TOMOGRAPHY AND MR IMAGING 578
COMPUTED TOMOGRAPHY 578
MR IMAGING 578
RADIOLOGIC FEATURES OF A MALIGNANT SINONASAL NEOPLASM 579
ROUTES OF DISEASE SPREAD WITH RELEVANT ANATOMY 582
Anterior and Middle Cranial Fossa 582
Pterygopalatine Fossa 582
Orbits 584
Dura 586
Perineural Spread 589
Nodal Disease 589
WHAT THE PHYSICIANS NEED TO KNOW (DIFFERENTIALS AND RESECTABILITY) 592
SUMMARY 593
REFERENCES 593
Sinonasal Tumors 595
Key points 595
INTRODUCTION 595
BENIGN AND MALIGNANT EPITHELIAL TUMORS 595
Papilloma 595
Squamous Carcinomas and Adenocarcinomas 596
Salivary Gland Neoplasms 597
NEUROENDOCRINE, NEUROECTODERMAL, NERVE SHEATH, AND NEURONAL TUMORS 598
Olfactory Neuroblastoma 598
Sinonasal Neuroendocrine Carcinoma and Sinonasal Undifferentiated Carcinoma 599
Melanoma 599
Ewing’s Sarcoma Family of Tumors 602
Peripheral Nerve Sheath Tumors 602
Meningioma 603
HEMATOLYMPHOID NEOPLASMS 603
Lymphoma 603
Plasma Cell Neoplasm 605
Chloroma 605
Langerhan’s Cell Histiocytosis 606
PRIMARY SOFT TISSUE TUMORS 606
Juvenile Nasopharyngeal Angiofibroma 606
Rhabdomyosarcoma 608
FIBROOSSEOUS LESIONS AND BONE SARCOMA 608
Osteoma 609
Fibrous Dysplasia 609
Ossifying Fibroma 610
Osteosarcoma 610
Chondrosarcoma 611
ODONTOGENIC TUMORS 616
Periodontal Cyst (Radicular Cyst) 616
Ameloblastoma 616
METASTASIS 616
SUMMARY 617
REFERENCES 617
The Skull Base in the Evaluation of Sinonasal Disease 619
Key points 619
INTRODUCTION 619
TECHNIQUES 619
ANATOMY 620
Median Anterior Skull Base: Applied Anatomy 620
Median Central Skull Base: Applied Anatomy 622
SINONASAL PATHOLOGY EXTENDING TO THE SKULL BASE 625
Neoplastic 625
Malignant 625
Direct extension 626
Perineural extension 631
Benign 632
Inflammatory and Infectious 632
Acute suppurative rhinosinusitis 632
Acute invasive fungal rhinosinusitis 633
Chronic sinonasal inflammation and infection 635
Mucoceles, polyps, and noninvasive fungal disease 635
SKULL BASE PATHOLOGY EXTENDING TO THE SINONASAL REGION 636
Intrinsic (Bony) Skull Base 637
Benign neoplasms 637
Malignant neoplasms 639
Others 640
Intracranial 643
Intracranial tumors 643
Cephaloceles 646
SUMMARY 647
REFERENCES 647
Posttreatment Imaging of the Paranasal Sinuses Following Endoscopic Sinus Surgery 653
Key points 653
INTRODUCTION 653
POSTOPERATIVE IMAGING TECHNIQUES AND PROTOCOLS 653
TYPES OF SURGERY AND IMAGING FINDINGS 654
Ostiomeatal Unit Endoscopic Sinus Surgery 654
Frontal Sinusotomy and Stenting 654
Sphenoidotomy 655
Balloon Sinuplasty 655
Mucocele Drainage 656
Sinonasal Debridement 656
Septoplasty and Septorhinoplasty 657
Inferior Turbinate Reduction and Turbinoplasty 658
Ophthalmic Indications for Endoscopic Sinus Surgery 658
SURGICAL COMPLICATIONS AND THEIR IMAGING FINDINGS 658
Skull Base and Intracranial Complications 658
Vascular Complications 660
Ophthalmic Complications 660
Recurrent Rhinosinusitis 662
Nasal Septum Injury 662
Empty Nose Syndrome 663
WHAT REFERRING PHYSICIANS NEED TO KNOW 664
SUMMARY 664
REFERENCES 664
Post-treatment Evaluation of Paranasal Sinuses After Treatment of Sinonasal Neoplasms 667
Key points 667
Introduction 667
Imaging techniques 668
Expected imaging changes after surgery 670
Expected imaging changes after radiation therapy 673
Imaging after surgery for osteoma 675
Imaging after surgery for inverted papilloma 676
Imaging after surgery for juvenile angiofibroma 678
Key facts in imaging local recurrences 679
Summary 683
References 683
Index 687