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
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