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Postoperative Bildgebung der Nasennebenhöhlen

Postoperative imaging of paranasal sinuses

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Zusammenfassung

Die radiologische Interpretation postoperativer Veränderungen der Nasennebenhöhlen erfordert das Wissen, warum und wie der Eingriff durchgeführt wurde bzw. welcher klinische Ausgangsbefund bestand. Es ist entscheidend, ob es sich um einen entzündlichen Prozess, ein rekonstruktives Vorgehen oder eine tumoröse Veränderung handelte.

Die Multidetektorcomputertomographie (MDCT) mit Auswertung im hochauflösenden Knochenfenster ist hinsichtlich der Bildgebung sowohl nach nichtfunktionellen bzw. funktionellen Verfahren bei entzündlichen Veränderungen als auch nach rekonstruktiven Eingriffen nach Gesichtsschädeltraumen oder vor Zahnimplantatsetzung die Methode der Wahl.

In der radiologischen Tumornachsorge repräsentieren die Kontrastmittel- (KM-)verstärkte MDCT mit Auswertung im Weichteil- und Knochenfenster und die Magnetresonanztomographie (MRT) den Standard. Insbesondere mit der KM-verstärkten multiplanaren MRT ist es in vielen Fällen möglich, zwischen Tumorrezidiv und entzündlichen Veränderungen zu unterscheiden und auch Knochenmarkveränderungen früher als mit der CT zu erfassen.

Abstract

The radiological interpretation of postoperative changes of the paranasal sinuses requires knowledge of why and how the surgical intervention was performed and what the basic clinical findings were. It is important to know whether there was an inflammation, a reconstructive procedure, or a tumorous process. Multidetector computed tomography (MDCT) evaluated in a high-resolution bone window level setting represents the method of choice for imaging after nonfunctional and functional procedures after inflammatory changes as well as for imaging after reconstructive surgery because of facial trauma or before dental implantation.

In the postoperative follow-up of tumor patients contrast-enhanced MDCT evaluated in a soft tissue window and bone window and especially magnetic resonance imaging (MRI) represent the standard. In many cases it is possible to differentiate tumor recurrence from inflammation with the help of contrast-enhanced multiplanar MRI and to detect bone marrow changes prior to CT.

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Authors and Affiliations

  1. Abt. für Osteologie, Klinik für Radiodiagnostik, AKH/Medizinische Universität Wien, Währinger Gürtel 18–20, 1090, Wien, Österreich

    S. Nemec & C. Czerny

  2. Klinik für Hals-, Nasen- und Ohrenheilkunde, AKH/Medizinische Universität Wien, Wien, Österreich

    M. Formanek

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  1. S. Nemec
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  2. M. Formanek
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  3. C. Czerny
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Correspondence to S. Nemec.

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Nemec, S., Formanek, M. & Czerny, C. Postoperative Bildgebung der Nasennebenhöhlen. Radiologe 47, 621–627 (2007). https://doi.org/10.1007/s00117-007-1506-8

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