The main role of imaging in these cases is to delineate the extent of disease for treatment planning. Arteriography Craniofacial Catheter angiography is typically not useful in the initial imaging evaluation of a sinonasal mass. It may be useful for preoperative planning, preoperative embolization of a vascular mass, or to treat severe epistaxis [43,48-50]. CT Cone Beam Paranasal Sinuses CBCT is not useful in the workup of patients with sinonasal mass because of the limitations in assessing soft-tissue structures. CT Head CT best depicts osseous changes, although it is limited in determining soft-tissue and intracranial extent. Although MRI is useful for evaluating intracranial extension of a sinonasal mass, contrast-enhanced CT can also be useful for evaluating the soft-tissue and intracranial extent of the mass [51]. CT maxillofacial is useful as the first-line CT examination for suspected sinonasal mass, but contrast-enhanced CT head may be added if increased coverage of the intracranial component of a mass and its associated mass effect of the intracranial structures is required. There is no relevant literature to support the use of noncontrast CT head or combined pre- and postcontrast CT imaging. CT Maxillofacial CT best depicts osseous changes and can help distinguish bony remodeling that is more typical of slow growing or benign masses from lytic destruction seen with more aggressive malignancies [7,51]. CT can demonstrate lesion mineralization, including the osseous matrix of osteomas, the chondroid matrix of cartilaginous tumors, and the ground glass density of fibro-osseous lesions. CT also best depicts invasion of the surrounding osseous structures, although it is limited in determining soft-tissue and intracranial extent and in distinguishing tumor from sinonasal inflammation. CT and MRI are complementary imaging modalities in the evaluation of sinonasal masses, localizing and characterizing lesions and determining their extent for treatment planning.
Sinonasal Disease. The main role of imaging in these cases is to delineate the extent of disease for treatment planning. Arteriography Craniofacial Catheter angiography is typically not useful in the initial imaging evaluation of a sinonasal mass. It may be useful for preoperative planning, preoperative embolization of a vascular mass, or to treat severe epistaxis [43,48-50]. CT Cone Beam Paranasal Sinuses CBCT is not useful in the workup of patients with sinonasal mass because of the limitations in assessing soft-tissue structures. CT Head CT best depicts osseous changes, although it is limited in determining soft-tissue and intracranial extent. Although MRI is useful for evaluating intracranial extension of a sinonasal mass, contrast-enhanced CT can also be useful for evaluating the soft-tissue and intracranial extent of the mass [51]. CT maxillofacial is useful as the first-line CT examination for suspected sinonasal mass, but contrast-enhanced CT head may be added if increased coverage of the intracranial component of a mass and its associated mass effect of the intracranial structures is required. There is no relevant literature to support the use of noncontrast CT head or combined pre- and postcontrast CT imaging. CT Maxillofacial CT best depicts osseous changes and can help distinguish bony remodeling that is more typical of slow growing or benign masses from lytic destruction seen with more aggressive malignancies [7,51]. CT can demonstrate lesion mineralization, including the osseous matrix of osteomas, the chondroid matrix of cartilaginous tumors, and the ground glass density of fibro-osseous lesions. CT also best depicts invasion of the surrounding osseous structures, although it is limited in determining soft-tissue and intracranial extent and in distinguishing tumor from sinonasal inflammation. CT and MRI are complementary imaging modalities in the evaluation of sinonasal masses, localizing and characterizing lesions and determining their extent for treatment planning.