Skip to main content
Log in

Radiologische Diagnostik der Nasennebenhöhlen

Radiological diagnosis of the paranasal sinuses

  • CME Weiterbildung · Zertifizierte Fortbildung
  • Published:
Der Radiologe Aims and scope Submit manuscript

Zusammenfassung

Erkrankungen der Nasennebenhöhlen können sich klinisch mit einem relativ einheitlichen Bild präsentieren, obwohl sehr unterschiedliche Ursachen vorliegen. Radiologische Untersuchungsmethoden haben erst nach Einführung der Schnittbilddiagnostik einen bedeutenden Stellenwert in der Abklärung von Erkrankungen des Kopf-Hals-Bereichs erlangt. Einleitend werden Untersuchungstechniken und ihre Bedeutung in der Analyse der Erkrankungen der Nasennebenhöhlen diskutiert. Neben den anatomischen Grundlagen und Normvarianten werden typische Befunde traumatischer Veränderungen und akuter entzündlicher Erkrankungen dargestellt. Zusammenfassend soll die Arbeit einen differenzierten Überblick über die Möglichkeiten und Grenzen der radiologischen Verfahren im Kopf-Hals-Bereich geben.

Abstract

Although diseases of the paranasal sinuses have a relatively homogeneous clinical presentation, their causes can vary considerably. Radiological imaging only became relevant in paranasal sinus diagnostics following the introduction of cross-sectional imaging. In addition to technical details on imaging procedures and the individual criteria of the different modalities, anatomic details and congenital variations are presented. Particularly in acute inflammatory diseases as well as traumatic lesions, imaging is essential in preoperative planning and postoperative control. The article gives a detailed description of options in radiologic imaging of the paranasal sinuses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6
Abb. 7
Abb. 8
Abb. 9
Abb. 10
Abb. 11
Abb. 12
Abb. 13
Abb. 14
Abb. 15
Abb. 16

Literatur

  1. Klose KC, Elies W, Sondermann U (1991) Treffsicherheit der Nativradiologie im Nachweis von Verschattungen der pneumatisierten Räume des Schädels – ein Vergleich mit der Computertomographie. Fortschr Röntgenstr 155:199–206

    Article  CAS  Google Scholar 

  2. DGHNO (2007) AWMF – aktualisierte Leitlinien für Diagnostik und Therapie Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Stand 5/07. URL: http://www.uni-duesseldorf.de/AWMF/ll/017–049.htm#kap06

  3. Dammann F, Bode A, Heuschmid M et al (2000) Mehrschicht-Spiral-CT der Nasennebenhöhlen: Erste Erfahrungen unter besonderer Berücksichtigung der Strahlenexposition. Fortschr Röntgenstr 172:701–706

    Article  CAS  Google Scholar 

  4. Tack D, Widelec J, De Maertelaer V et al (2003) Comparison between low-dose and standard-dose multidetector CT in patients with suspected chronic sinusitis. AJR Am J Roentgenol 181:939–944

    PubMed  Google Scholar 

  5. Dos Santos DT, Costa e Silva AP, Vannier MW et al (2004) Validity of multislice computerized tomography for diagnosis of maxillofacial fractures using an independent workstation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:715–720

    Article  Google Scholar 

  6. White ML, Zhang Y, Robinson RA (2006) Evaluating tumors and tumorlike lesions of the nasal cavity, the paranasal sinuses and the adjacent skull base with diffusion-weighted MRI. J Comput Assist Tomogr 30:490–495

    Article  PubMed  Google Scholar 

  7. Fritsch MH, Mosier KM (2007) MRI compatibility issues in otology. Curr Opin Otolaryngol Head Neck Surg 15:335–340

    Article  PubMed  Google Scholar 

  8. Fritsch MH (2007) MRI scanners and the stapes prosthesis. Otol Neurotol 28:733–738

    Article  Google Scholar 

  9. Turowski B, Zanella FE (2003) Interventional neuroradiology of the head and neck. Neuroimaging Clin N Am 13:619–645

    Article  PubMed  Google Scholar 

  10. Zanella FE, Valavanis A (1994) Interventional neuroradiology of lesions of the skull base. Neuroimaging Clin N Am 4:619–637

    CAS  PubMed  Google Scholar 

  11. Som PM, Shugar JMA, Brandwein M (2003) Anatomy and physiology. Head Neck Imaging 1:87–149

    Google Scholar 

  12. Som PM, Brandwein M (2003) Inflammatory diseases. Head Neck Imaging 1:193–261

    Google Scholar 

  13. Rao VM, el-Noueam KI (1998) Sinonasal imaging. Anatomy and pathology. Radiol Clin North Am 36:921–939, vi

    Article  CAS  PubMed  Google Scholar 

  14. Kantarci M, Karasen RM, Alper F et al (2004) Remarkable anatomic variations in paranasal sinus region and their clinical importance. Eur J Radiol 50:296–302

    Article  PubMed  Google Scholar 

  15. Zimmermann K, Heider C, Kosling S (2007) Anatomie und Normvarianten der Nasennebenhöhlen in der Schnittbildgebung. Radiologe 47:584–590

    Article  CAS  PubMed  Google Scholar 

  16. Bayram M, Sirikci A, Bayazit YA (2001) Important anatomic variations of the sinonasal anatomy in light of endoscopic surgery: a pictorial review. Eur Radiol 11:1991–1997

    Article  CAS  PubMed  Google Scholar 

  17. Naidich TP, Blaser SI, Bauer BS et al (2003) Embryology andcongenital lesions of the midface. In: Som PM, Curtin HD (eds) Head and neck imaging, 4th ed. Mosby, St Louis, pp 3–86

  18. Hisatomi M, Asaumi J, Konouchi H et al (2003) MR imaging of epithelial cysts of the oral and maxillofacial region. Eur J Radiol 48:178–182

    Article  PubMed  Google Scholar 

  19. Kösling S, Wagner F, Schulz HG (1993) Knöcherne Varianten im koronaren CT der Nasennebenhöhlen. Fortschr Röntgenstr 159:506–510

    Article  Google Scholar 

  20. Schuknecht B, Graetz K (2005) Radiologic assessment of maxillofacial, mandibular and skull base trauma. Eur Radiol 15:560–568

    Article  PubMed  Google Scholar 

  21. Som PM, Brandwein M (2003) Facial fractures and postoperative findings. Head Neck Imaging 1:374–441

    Google Scholar 

  22. Lambert DM, Mirvis SE, Shanmuganathan K et al (1997) Computed tomography exclusion of osseous paranasal sinus injury in blunt trauma patients: the „clear sinus“ sign. J Oral Maxillofac Surg 55:1207–1210

    Article  CAS  PubMed  Google Scholar 

  23. Buitrago-Tellez CH, Kunz H (2001) Bildgebende Diagnostik bei Gesichtsschädelfrakturen und Traumafolgen. Radiol Up2Date 1:371–401

    Article  Google Scholar 

  24. Rak KM, Newell JD 2nd, Yakes WF et al (1991) Paranasal sinuses on MR images of the brain: significance of mucosal thickening. AJR Am J Roentgenol 156:381–384

    CAS  PubMed  Google Scholar 

  25. Vogl TJ, Mack MG, Balzer J (2000) Chronische Infektionen der Nasennebenhöhlen. Radiologe 40:500–506

    Article  CAS  PubMed  Google Scholar 

  26. Vogl TJ (1997) Radiologische Differentialdiagnostik in der Kopf/Hals-Region

  27. Mack MG, May A, Bisdas S et al (2007) Bildgebung bei entzündlichen Erkrankungen der Nasennebenhöhlen. Radiologe 47:606–612

    Article  CAS  PubMed  Google Scholar 

  28. Eustis HS, Mafee MF, Walton C et al (1998) MR imaging and CT of orbital infections and complications in acute rhinosinusitis. Radiol Clin North Am 36:1165–1183, xi

    Article  CAS  PubMed  Google Scholar 

  29. Curtin HD, Rabinov JD (1998) Extension to the orbit from paraorbital disease. The sinuses. Radiol Clin North Am 36:1201–1213, xi

    Article  CAS  PubMed  Google Scholar 

  30. Younis RT, Anand VK, Davidson B (2002) The role of computed tomography and magnetic resonance imaging in patients with sinusitis with complications. Laryngoscope 112:224–229

    Article  PubMed  Google Scholar 

  31. Yoon JH, Na DG, Byun HS et al (1999) Calcification in chronic maxillary sinusitis: comparison of CT findings with histopathologic results. AJNR Am J Neuroradiol 20:571–574

    CAS  PubMed  Google Scholar 

  32. Krennmair G, Lugmayr H, Lenglinger F (1993) Röntgendichte Strukturen im Lumen der Kieferhöhlen – Wertigkeit der Coputertomographie in der Diagnostik der maxillären Aspergillose. Fortschr Röntgenstr 158:197–200

    Article  CAS  Google Scholar 

  33. Mukherji SK, Figueroa RE, Ginsberg LE et al (1998) Allergic fungal sinusitis: CT findings. Radiology 207:417–422

    CAS  PubMed  Google Scholar 

  34. Benninger MS, Ferguson BJ, Hadley JA et al (2003) Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology and pathophysiology. Otolaryngol Head Neck Surg 129:S1–S32

    Article  PubMed  Google Scholar 

  35. Seitz J, Strotzer M, Held P (1995) Das juvenile Nasenrachenangiofibrom und der antro-choanale Polyp: Rolle der MRT in der Differentialdiagnostik. Fortschr Röntgenstr 162:442–443

    Article  CAS  Google Scholar 

  36. Chong VF, Fan YF (1998) Comparison of CT and MRI features in sinusitis. Eur J Radiol 29:47–54

    Article  CAS  PubMed  Google Scholar 

  37. Zinreich SJ, Albayram S, Benson ML et al (2003) The ostiomeatal complex and functional endoscopic surgery. Head Neck Imaging 1:149–175

    Google Scholar 

  38. Mantoni M, Larsen P, Hansen H et al (1996) Coronal CT of the paranasal sinuses before and after functional endoscopic sinus surgery. Eur Radiol 6:920–924

    Article  CAS  PubMed  Google Scholar 

  39. Barzilai G, Greenberg E, Uri N (2005) Indications for the Caldwell-Luc approach in the endoscopic era. Otolaryngol Head Neck Surg 132:219–220

    Article  PubMed  Google Scholar 

  40. Hudgins PA, Kingom TT (2003) Postoperative complications of fuctional endoscopic sinus surgery. Head Neck Imaging 1:175–193

    Google Scholar 

  41. Bhatti MT, Schmalfuss IM, Mancuso AA (2005) Orbital complications of functional endoscopic sinus surgery: MR and CT findings. Clin Radiol 60:894–904

    Article  CAS  PubMed  Google Scholar 

  42. Som PM, Brandwein M (2003) Tumors and tumor-like conditions. In: Som PM, Curtin HD (eds) Head and neck imaging, 3rd edn. Mosby, St. Louis, pp 261–374

  43. Wittekind C, Greene FL, Hutter RVP et al (eds) (2005) TNM atlas: illustrated guide to the TNM classification of malignant tumours, 5th edn. Wiley & Sons, Hoboken

  44. Weiss F, Habermann CR, Welger J et al (2001) MRI in the preoperative diagnosis of chronic sinusitis: comparison with CT. Fortschr Röntgenstr 173:319–324

    Article  CAS  Google Scholar 

  45. Chin SC, Fatterpekar G, Chen CY et al (2003) MR imaging of diverse manifestations of nasopharyngeal carcinomas. AJR Am J Roentgenol 180:1715–1722

    PubMed  Google Scholar 

  46. Manavis J, Sivridis L, Koukourakis MI (2005) Nasopharyngeal carcinoma: the impact of CT-scan and of MRI on staging, radiotherapy treatment planning and outcome of the disease. Clin Imaging 29:128–133

    PubMed  Google Scholar 

  47. Maroldi R, Ravanelli M, Borghesi A et al (2008) Paranasal sinus imaging. Eur J Radiol 66:372–386

    Article  PubMed  Google Scholar 

  48. Hermans R, De Vuysere S, Marchal G (1999) Squamous cell carcinoma of the sinonasal cavities. Semin Ultrasound CT MR 20:150–161

    Article  CAS  PubMed  Google Scholar 

  49. Liu HM, Hung JJ, Huang KM (2002) Comparison of contrast-enhanced magnetization transfer imaging and contrast-enhanced fat saturation T1-weighted imaging in nasopharyngeal carcinoma. J Comput Assist Tomogr 26:805–809

    Article  PubMed  Google Scholar 

  50. King AD, Lei KI, Richards PS et al (2003) Non-Hodgkin’s lymphoma of the nasopharynx: CT and MR imaging. Clin Radiol 58:621–625

    Article  CAS  PubMed  Google Scholar 

  51. Weber AL, Rahemtullah A, Ferry JA (2003) Hodgkin and non-Hodgkin lymphoma of the head and neck: clinical, pathologic and imaging evaluation. Neuroimaging Clin N Am 13:371–392

    Article  PubMed  Google Scholar 

  52. Connor SE, Umaria N, Chavda SV (2001) Imaging of giant tumours involving the anterior skull base. Br J Radiol 74:662–667

    CAS  PubMed  Google Scholar 

  53. Greenspan A (1993) Benign bone-forming lesions: osteoma, osteoid osteoma and osteoblastoma. Clinical, imaging, pathologic and differential considerations. Skeletal Radiol 22:485

    CAS  PubMed  Google Scholar 

  54. Tehranzadeh J, Fung Y, Donohue M et al (1998) Computed tomography of Paget disease of the skull versus fibrous dysplasia. Skeletal Radiol 27:664–672

    Article  CAS  PubMed  Google Scholar 

  55. Dammann F, Pereira P, Laniado M et al (1999) Inverted papilloma of the nasal cavity and the paranasal sinuses: using CT for primary diagnosis and follow-up. AJR Am J Roentgenol 172:543–548

    CAS  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Cohnen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cohnen, M. Radiologische Diagnostik der Nasennebenhöhlen. Radiologe 50, 277–296 (2010). https://doi.org/10.1007/s00117-009-1976-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00117-009-1976-y

Schlüsselwörter

Keywords

Navigation