CT of sinusitis

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Author: Mikael Häggström [notes 1]

Planning

Settings

  • A low-dose CT without contrast is generally sufficient in suspected acute sinusitis.
  • Normal radiation dose is indicated in suspected chronic sinusitis.
  • Imaging without and with IV contrast is indicated in a suspected facio-maxillary abscess.

Evaluation

Right-sided chronic sinusitis, with sclerotic thickened wall.
  • Mucus content in paranasal sinuses, particularly the ostiomeatal complex.
If detected, measure the attenuation of the mucus. Acute sinus secretions have a radiodensity of 10 to 25 Hounsfield units, but in a more chronic state they become more viscous, with a radiodensity of 30 to 60 HU.[1]
  • Any sclerotic thickening of the walls of the sinuses, indicating chronic sinusitis.
  • Any abnormal protrusion of teeth into the maxillary sinuses.[2]
  • Any mucus or fluid in mastoid cells or the middle ear.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. Page 674 in: Paul W. Flint, Bruce H. Haughey, John K. Niparko, Mark A. Richardson, Valerie J. Lund, K. Thomas Robbins, Marci M. Lesperance, J. Regan Thomas (2010). Cummings Otolaryngology – Head and Neck Surgery: Head and Neck Surgery, 3-Volume Set . Elsevier Health Sciences. ISBN 9780323080873. 
  2. Scheinfeld, Meir H.; Shifteh, Keivan; Avery, Laura L.; Dym, Harry; Dym, R. Joshua (2012). "Teeth: What Radiologists Should Know ". RadioGraphics 32 (7): 1927–1944. doi:10.1148/rg.327125717. ISSN 0271-5333.