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.
