Magnetic resonance imaging is a relatively new way to visualize anatomical structures. It allows you to study the structure of the area of interest to a specialist, layer by layer, which increases the accuracy of diagnosis, helps, if necessary, to plan an operation. MRI is widely used in otolaryngology as a highly sensitive method that provides information on the localization and prevalence of the pathological process. This simplifies and makes more rapid diagnostic search for ENT diseases. One of the probable indications for the purpose of the study is the pathology of the paranasal sinuses. What does the MRI show in this case? Every patient should know about this.
MRI method
MRI of the paranasal sinuses - what is it and why is it done? Magnetic resonance imaging, abbreviated as MRI, is a progressive, but at the same time, complex method. It is often referred to as a universal diagnostic method that completely replaces X-rays, but this is completely wrong. MRI does not allow assessing the state of the whole organism as a whole during one session. Like any other imaging method, it requires a targeted prescription - the referring physician specifies the area of the diagnostic search. At the same time, the information content of tomography for different diseases is different, so it should be carried out only if there are clear indications. Examination of the nasal region allows you to obtain a display of the intranasal anatomical structures, to examine the structure of the sinuses (sinuses).
Conclusion MRI is not a diagnosis.
The images obtained during the procedure, as well as the opinion of the radiologist, are intended for the specialist who sent them for examination (during the MRI of the paranasal sinuses - the ENT doctor). The clinical diagnosis is established on the basis of a set of data - including the indication of changes detected by magnetic resonance imaging.
The method has a number of advantages:
- No radiation exposure (X-ray radiation is not applied).
- High resolution.
- The absence of artifacts, the appearance of which with other methods is due to the presence in the investigated area of bone tissue, filling material.
At the same time, magnetic resonance imaging cannot be performed:
- patients who have metal prostheses of any localization;
- patients who have an artificial pacemaker.
It is forbidden to bring metal elements into the room where the procedure is carried out, therefore the presence of fixed metal prostheses is an indication for choosing an alternative diagnostic method. If you have a pacemaker, you should also skip MRI because the heart rhythm may fail.
What does an MRI of the sinuses show? Although the method is not the main one in the diagnosis of ENT pathology, it can be used in combination with radiography, computed tomography (CT) to confirm the presence of inflammatory changes, neoplasms.
Sinusitis
Sinusitis is a collective name for inflammatory diseases of the paranasal sinuses. In this case, MRI is used to:
- diagnostics of intracranial complications;
- diagnostics of intraorbital complications;
- differential diagnosis of inflammation of various etiologies.
MRI of the paranasal sinuses makes it possible to establish the presence and prevalence of rhinosinusogenic (that is, provoked by a pathological process in the nasal cavity and sinuses) complications. Among the intracranial complications of sinusitis, there are such as:
- Inflammation of the lining of the brain (meningitis).
- Inflammation of the brain (encephalitis).
- Abscesses of various localization.
- Cavernous sinus thrombosis.
Intraorbital, that is, intraorbital complications include:
- cellulite (preseptal, orbital);
- subperiosteal abscess;
- phlegmon of the orbit.
In some cases, MRI results need to be supplemented with CT results.
Magnetic resonance imaging is used for the differential diagnosis of mycotic (fungal) sinusitis from sinusitis of a different etiology. The study is prescribed for both acute and chronic forms of the course of the disease. The results obtained during the procedure help in the choice of etiotropic therapy.
Cysts, tumors
MRI of the sinuses provides information about various formations located in tissues that are not part of the normal anatomical structure. When conducting research, you can:
- Identify cysts, tumors.
- Differentiate tumor tissue from secondary inflammatory changes.
- Get an accurate idea of the boundaries of the localization of the neoplasm.
The purpose of MRI is to differentiate tumor, reactive effusion and mucosal edema.
Magnetic resonance imaging helps to visualize soft tissues, assess inflammatory exudate. In many cases, a combination with computed tomography is required, which is designed to detect changes in bone structures. With the results of magnetic resonance imaging, the doctor is able to plan the stages of surgery, assess the likely complications and predict the expected outcome of the operation.
One of the advantages of the method is a clearer visualization of the neoplasm in comparison with the image on an X-ray and computed tomogram. This is due to the fact that a zone of reactive inflammation is formed around the tumors, which contributes to an increase in the area of pathological changes on X-ray and CT. However, when examining by means of MRI, you can see the difference between the signals of inflamed tissues and tumor tissues.
MRI with contrast
A contrast agent is a drug that is administered to improve visualization of pathological changes in anatomical structures. The need for contrasting is usually dictated by the need to clarify the characteristics of the neoplasm. The study evaluates:
- localization of the tumor;
- the size of the tumor;
- the structure and boundaries of the tumor;
- prevalence of vessels and nerves.
Based on the research data, malignant and benign neoplasms are differentiated. In the first case, the tumor is characterized by a heterogeneous structure, lack of clear contours and irregular shape. The surrounding tissues, as a rule, are infiltrated, there are signs of secondary inflammation. Benign tumors have clear boundaries, but the prognosis depends on the location and size of the neoplasm.
