Imaging modalities in

ESS
Imaging modalities in ESS
1. CT
2. MRI
3. Angiography
4. Dacrocystogram and lacrimal
scintillography
1 Computed tomography
• Used for:
• the diagnosis of chronic
• sinusitis and for the planning of the
• surgery
• (reconstruct the anatomy and drainage
pathways of the sinuses)
• Before CT:
Adequate medical TTT for 10 to14 days of
acute cases
How to order it:
Coronal view is the conventional study
• Full study:
• CT nose and paranasal sinuses coronal
axial and sagittal bone or soft tissue window
with or without 3D reconstruction
• CT scan imaging protocol on a multislice
• CT helical scanner requires scans to be performed in the
• axial plane at 0.5- to 1-mm intervals with coronal and
parasagittal reconstruction
• The windows of the scan are set at between
• 1500 and 2000 with a center of 1100 to 1300 for highest
• bony defnition
MRI
• (MRI) scans are not routinely used for the
assessment of patients undergoing ESS as
they do not provide bony defnition.
MRI
• It tells us whether an opacifed sinus is flled
with tumor or retained mucus and whether
an invasion of the dura or orbital periosteum
has occurred
MRI
Angiography
useful in patients who have a suspected
vascular tumor and an attempt is to be made
to remove this tumor endoscopically
Dacrocystogram and lacrimal
scintillography
• (DCG) can be useful for assessing the
anatomy of the nasolacrimal system
DCG reveals flow of dye from the canaliculus
to the nose
It is not a physiologic test as abnormally high
pressures are generated in the nasolacrimal
system during injection of the dye
lacrimal scintillography can be very useful as
the placement of a radioisotope in the tear
lake with subsequent detection of its passage
into the nasolacrimal system and nose