Evaluation of preoperative imaging techniques in inflammatory sinus disease

Objective Computed tomography (CT), along with endoscopy, is considered a standard guideline-based investigation method in the assessment of chronic rhinosinusitis and diseases of the paranasal sinus system (PNS). MRIs are often performed in acute situations. While conventional radiography is generally considered obsolete, the value of ultrasound (US) of the PNS is controversial.

Methods In this presentation, current imaging methods are presented and compared with the literature with regard to their diagnostic quality. Study results of the Working Group on Ultrasound and Imaging Techniques are also critically discussed.

Results CT has the highest diagnostic accuracy (on average a sensitivity of >90%) in the assessment of pathology of the PNS. MRI diagnosis is indicated as primary or solitary imaging only in special clinical constellations (complications, radiation protection). While US is able to provide an orientational assessment of pathology of all PNS, the accuracy in the assessment of inflammatory entities with computed tomography is, however, significantly higher.

Discussion Data from the literature does confirm the value of CT in treatment planning for pathologies of the PNS. MRI examinations are used in special situations, while conventional X-ray film is of little importance. Ultrasound is excellent to use in daily routine, but has a lower accuracy. Nevertheless, ultrasound diagnostics can be used as a complementary available method for screening, follow-up or the identification of complications for the diagnosis of the PNS.

Publikationsverlauf

Artikel online veröffentlicht:
12. Mai 2023