Decreased T2 signal and apparent diffusion coefficient correlate with increased cellularity of tumors [9]. Perfusion MRI can also potentially provide diagnostic information of sinonasal masses [52,53]. For tumor mapping, MRI is more helpful than CT for soft tissue contrast and can better distinguish tumors from the more T2 hyperintense sinus inflammatory changes and retained secretions. MRI can also best identify intracranial and perineural involvement important for staging and presurgical planning [7,24]. Compared with CT, MRI can also better detect osseous marrow invasion. CT and MRI are complementary imaging modalities in the evaluation of sinonasal masses, localizing and characterizing lesions, and determining their extent for treatment planning. Radiography Paranasal Sinuses Radiography is not considered to be part of the imaging workup of sinonasal neoplasms [51]. SPECT or SPECT/CT Paranasal Sinuses There is no relevant literature to support the use of SPECT or SPECT/CT in the evaluation of a sinonasal mass. Arteriography Craniofacial There is no relevant literature to support the use of arteriography in the evaluation of sinonasal CSF leak. CT Cone Beam Paranasal Sinuses There is no relevant literature regarding the use of CBCT paranasal sinuses in the evaluation of sinonasal CSF leak. CT Head Cisternography CT head cisternography is performed by spinal injection of intrathecal contrast, with images performed before and after contrast administration. Interval contrast pooling adjacent to an osseous defect can be identified with demonstration of a 50% or greater increase in Hounsfield units between the pre- and postcontrast scans [12]. CT head cisternography is primarily used in the setting of multiple osseous defects on high-resolution CT (HRCT) to Sinonasal Disease determine the specific site of the leak [12]. CT cisternography has a reported sensitivity of 33% to 100% and a specificity of 94% [12,13,55-58].
Sinonasal Disease. Decreased T2 signal and apparent diffusion coefficient correlate with increased cellularity of tumors [9]. Perfusion MRI can also potentially provide diagnostic information of sinonasal masses [52,53]. For tumor mapping, MRI is more helpful than CT for soft tissue contrast and can better distinguish tumors from the more T2 hyperintense sinus inflammatory changes and retained secretions. MRI can also best identify intracranial and perineural involvement important for staging and presurgical planning [7,24]. Compared with CT, MRI can also better detect osseous marrow invasion. CT and MRI are complementary imaging modalities in the evaluation of sinonasal masses, localizing and characterizing lesions, and determining their extent for treatment planning. Radiography Paranasal Sinuses Radiography is not considered to be part of the imaging workup of sinonasal neoplasms [51]. SPECT or SPECT/CT Paranasal Sinuses There is no relevant literature to support the use of SPECT or SPECT/CT in the evaluation of a sinonasal mass. Arteriography Craniofacial There is no relevant literature to support the use of arteriography in the evaluation of sinonasal CSF leak. CT Cone Beam Paranasal Sinuses There is no relevant literature regarding the use of CBCT paranasal sinuses in the evaluation of sinonasal CSF leak. CT Head Cisternography CT head cisternography is performed by spinal injection of intrathecal contrast, with images performed before and after contrast administration. Interval contrast pooling adjacent to an osseous defect can be identified with demonstration of a 50% or greater increase in Hounsfield units between the pre- and postcontrast scans [12]. CT head cisternography is primarily used in the setting of multiple osseous defects on high-resolution CT (HRCT) to Sinonasal Disease determine the specific site of the leak [12]. CT cisternography has a reported sensitivity of 33% to 100% and a specificity of 94% [12,13,55-58].