Given its detailed depiction of bony anatomy, CT can also accurately demonstrate the presence of erosions of the sinus and orbital walls. Studies have demonstrated a higher accuracy of CT compared with clinical examination for detecting orbital complications, with an accuracy of 87% to 91% [23]. CT also enables surgical planning given its detailed depiction Sinonasal Disease of sinonasal anatomy and can be used for surgical image-guidance systems. Although MRI is overall more useful than CT for the evaluation of intracranial and intraorbital complications, CT is often the first imaging study ordered. A noncontrast CT may be performed for bony evaluation and surgical planning but is limited in the detection of orbital and intracranial complications. There is no relevant literature to support the use of combined pre- and postcontrast CT imaging. CTA Head CTA head may be performed for the evaluation of a pseudoaneurysm, but this is typically not performed in the initial imaging evaluation. There is no relevant literature to support the use of CTA head in the evaluation of ARS with suspected orbital or intracranial complication. FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/CT in the evaluation of ARS with suspected orbital or intracranial complication. MRA Head MRA head may be performed for the evaluation of a pseudoaneurysm, but this is typically not performed in the initial imaging evaluation. There is no relevant literature to support the use of MRA head in the evaluation of ARS with suspected orbital or intracranial complication. MRI Head MRI head without and with IV contrast can accurately identify clinically suspected intracranial complications including cavernous sinus thrombosis, epidural abscess, subdural empyema, cerebritis, brain abscess, and meningitis, with a reported 97% diagnostic accuracy compared with 87% for CT and a superior accuracy in particular for the diagnosis of meningitis [17,23].
Sinonasal Disease. Given its detailed depiction of bony anatomy, CT can also accurately demonstrate the presence of erosions of the sinus and orbital walls. Studies have demonstrated a higher accuracy of CT compared with clinical examination for detecting orbital complications, with an accuracy of 87% to 91% [23]. CT also enables surgical planning given its detailed depiction Sinonasal Disease of sinonasal anatomy and can be used for surgical image-guidance systems. Although MRI is overall more useful than CT for the evaluation of intracranial and intraorbital complications, CT is often the first imaging study ordered. A noncontrast CT may be performed for bony evaluation and surgical planning but is limited in the detection of orbital and intracranial complications. There is no relevant literature to support the use of combined pre- and postcontrast CT imaging. CTA Head CTA head may be performed for the evaluation of a pseudoaneurysm, but this is typically not performed in the initial imaging evaluation. There is no relevant literature to support the use of CTA head in the evaluation of ARS with suspected orbital or intracranial complication. FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/CT in the evaluation of ARS with suspected orbital or intracranial complication. MRA Head MRA head may be performed for the evaluation of a pseudoaneurysm, but this is typically not performed in the initial imaging evaluation. There is no relevant literature to support the use of MRA head in the evaluation of ARS with suspected orbital or intracranial complication. MRI Head MRI head without and with IV contrast can accurately identify clinically suspected intracranial complications including cavernous sinus thrombosis, epidural abscess, subdural empyema, cerebritis, brain abscess, and meningitis, with a reported 97% diagnostic accuracy compared with 87% for CT and a superior accuracy in particular for the diagnosis of meningitis [17,23].