If an MRI is also planned or performed, the CT can be performed without IV contrast because the main purpose of the CT is to evaluate osseous involvement. Although MRI is superior for evaluating the soft tissues, contrast-enhanced CT can also be useful for evaluating the soft-tissue and intracranial extent of the mass [51]. CT maxillofacial also enables surgical planning given its detailed depiction of sinonasal anatomy and can be used with surgical image-guidance systems when acquired with the appropriate protocol. CTA Head CTA head is typically not useful in the initial imaging evaluation of a sinonasal mass. It may be useful for preoperative planning of a vascular mass [43,48-50]. Sinonasal Disease FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT is not useful for the initial evaluation of a sinonasal mass but can be used to detect regional and distant metastases in the staging workup of malignant neoplasms [7]. MRA Head MRA head typically is not useful in the initial imaging evaluation of a sinonasal mass. It may be useful for preoperative planning of a vascular mass [43,48-50]. MRI Head MRI head may be performed in addition to the MRI maxillofacial examination if increased coverage of the intracranial component of a mass and its associated mass effect of the intracranial structures is required. Combined pre- and postcontrast imaging provides the best opportunity to identify intracranial extension and to characterize potential intracranial complications. MRI Orbits, Face, and Neck MRI without and with IV contrast can best characterize the soft-tissue components of a mass and can occasionally demonstrate signal characteristics suggestive of specific pathology. For example, MRI can demonstrate the convoluted cerebriform pattern of inverted papillomas on T2-weighted and contrast-enhanced T1-weighted MRI; the intrinsic T1 hyperintensity of melanotic melanomas; and peritumoral intracranial cysts, which are suggestive of, but not specific for, esthesioneuroblastoma [7,8].
Sinonasal Disease. If an MRI is also planned or performed, the CT can be performed without IV contrast because the main purpose of the CT is to evaluate osseous involvement. Although MRI is superior for evaluating the soft tissues, contrast-enhanced CT can also be useful for evaluating the soft-tissue and intracranial extent of the mass [51]. CT maxillofacial also enables surgical planning given its detailed depiction of sinonasal anatomy and can be used with surgical image-guidance systems when acquired with the appropriate protocol. CTA Head CTA head is typically not useful in the initial imaging evaluation of a sinonasal mass. It may be useful for preoperative planning of a vascular mass [43,48-50]. Sinonasal Disease FDG-PET/CT Skull Base to Mid-Thigh FDG-PET/CT is not useful for the initial evaluation of a sinonasal mass but can be used to detect regional and distant metastases in the staging workup of malignant neoplasms [7]. MRA Head MRA head typically is not useful in the initial imaging evaluation of a sinonasal mass. It may be useful for preoperative planning of a vascular mass [43,48-50]. MRI Head MRI head may be performed in addition to the MRI maxillofacial examination if increased coverage of the intracranial component of a mass and its associated mass effect of the intracranial structures is required. Combined pre- and postcontrast imaging provides the best opportunity to identify intracranial extension and to characterize potential intracranial complications. MRI Orbits, Face, and Neck MRI without and with IV contrast can best characterize the soft-tissue components of a mass and can occasionally demonstrate signal characteristics suggestive of specific pathology. For example, MRI can demonstrate the convoluted cerebriform pattern of inverted papillomas on T2-weighted and contrast-enhanced T1-weighted MRI; the intrinsic T1 hyperintensity of melanotic melanomas; and peritumoral intracranial cysts, which are suggestive of, but not specific for, esthesioneuroblastoma [7,8].