IMAGING IN PNS DR MUDASIR UL ISLAM

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pns imaging

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IMAGING IN PNS:

IMAGING IN PNS DR MUDASIR UL ISLAM

WHY CT SCAN?:

WHY CT SCAN ? 1. TO STUDY ANATOMY AND VARIATIONS 2. TO STUDY DISEASE AND ITS EXTENT 3. TO PLAN FOR SURGERY 4. POST .OPERATIVE.

VARIOUS CUTS:

VARIOUS CUTS 1. CORONAL 2. AXIAL 3. SAGITTAL

CORONAL CUTS:

CORONAL CUTS POSITION PRONE, CHIN HYPER-EXTENDED. SCANNER GANTRY IS ANGLED PERPENDICULAR TO HARD PALATE. FROM ANTERIOR WALL OF FRONTAL SINUS THROUGH POSTERIOR WALL OF SPHENOID SINUS.

CORONAL :

CORONAL ADVANTAGES 1.SURGEON S VIEW 2. OSTEOMEATAL UNIT BETTER VISUALISED 3.RELATIONSHIP OF BRAIN TO THE ETHMOID ROOF PITTFALLS 1.ANTERIOR AND POSTERIOR WALLS OF THE FRONTAL, MAXILLARY AND SPHENOID SINUSES --------NOT WELL SEEN 2. NECK EXTENSION ----PATIENT COMPLIANCE

Frontal cells type 1:

Frontal cells type 1

Type 2:

Type 2

Type 3:

Type 3

Type 4:

Type 4

AXIAL STUDY:

AXIAL STUDY POSITION Patient supine, hard palate perpendicular to table top Scanning plane parallel to the inferior orbito - meatal line From a level just above the top of frontal sinuses to the bottom of maxillary teeth.

Why axial:

Why axial 1. optic nerve 2.naso lacrimal duct 3.speno palatine foramen 4.bone dehicence

SAGITTAL CUTS:

SAGITTAL CUTS 1. FRONTAL CELLS 2.FRONTAL RECESS 3.SKULL BASE

ANATOMICAL VARIATIONS:

ANATOMICAL VARIATIONS Nasal septal deviation

Right sided septal deviation:

Right sided septal deviation

Uncinate attachment variations:

Uncinate attachment variations

Pneumatisation of uncinate:

Pneumatisation of uncinate

VARIATIONS OF MIDDLE TURBINATE:

VARIATIONS OF MIDDLE TURBINATE

Paradoxical turbinate:

Paradoxical turbinate

Concha bullosa:

Concha bullosa

Infra orbital ethmoid cells{Haller’s Cells}:

Infra orbital ethmoid cells{Haller’s Cells}

ONODI CELLS:

ONODI CELLS

Extensive pneumatisation of ethmoid bulla:

Extensive pneumatisation of ethmoid bulla

Aerated crista gallI:

Aerated crista gallI

KERO S CLASSIFICATION FOR OLFACTORY FOSSA:

KERO S CLASSIFICATION FOR OLFACTORY FOSSA

KEROS 1:

KEROS 1

KEROS 2:

KEROS 2

KEROS 3:

KEROS 3

PATOLOGICAL CONDITIONS:

PATOLOGICAL CONDITIONS INFLAMMATORY SINUS DISEASE

ACUTE SINUSITIS:

ACUTE SINUSITIS

CHRONIC SINUSITIS:

CHRONIC SINUSITIS

FUNGAL SINUSITIS:

FUNGAL SINUSITIS

CARCINOMA :

CARCINOMA

MRI:

MRI 1. MRI is extremely helpful in complicated sinonasal disease 2. MRI can discern secretions and mucosa from masses 3. Also look for foraminal extension, whether by perineural spread or direct invasion of the tumor 2. Infiltration of the dura and the cerebrum can be depicted

SINUSITIS:

SINUSITIS

FUNGAL SINUSITIS:

FUNGAL SINUSITIS

CARCINOMA:

CARCINOMA

USG OF PARANASAL SINUSES:

USG OF PARANASAL SINUSES has been proposed as a diagnostic procedure intended to determine the presence of sinus fluid in clinical cases of sinusitis also proposed for use in demonstrating mucosal wall thickening, focal soft tissue masses, and complex collections in the paranasal Sinuses

Normal maxillary sinus:

Normal maxillary sinus

Fluid filled maxillary sinus:

Fluid filled maxillary sinus

Pet ct scan:

Pet ct scan clinical PET imaging relies on [18F] fluorodeoxy -glucose (FDG) uptake. Increased glycolysis in tumor cells is referred to as the Warburg effect

Pet scan:

Pet scan

PowerPoint Presentation:

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