[MRI in the preoperative diagnosis of chronic sinusitis: comparison with CT].
OBJECTIVE
To determine the value of MRI in the preoperative evaluation of chronic paranasal sinusitis and to compare the results with CT and intraoperative findings.


METHODS
42 patients with clinical signs of chronic paranasal sinusitis underwent MRI after CT evaluation on one day, with subsequent functional endoscopic sinus surgery on the next day. Coronary CT was obtained with 5-mm slices and table-feed in the prone position, while MRI was performed in the supine position with coronary T2-TSE + pd and coronary and transverse HASTE, each with 5-mm slice thickness. Aquisition time in MRI was less than 8 minutes. Two radiologists reviewed the CT and MRI scans for signs of sinusitis and detection of anatomical landmarks. The results were correlated with the intraoperative findings.


RESULTS
MRI offered no artifacts of dental work and showed more often high quality pictures than CT. CT and MRI demonstrated a good correlation in the detection of mucosal pathologies (kappa = 0.46-0.87) and anatomic variants (kappa = 0.55-0.86). All important anatomical structures could be evaluated sufficiently with MRI for preoperative management. Both diagnostic tools showed an unsatisfactory correlation with intraoperative findings in the ethmoidal complex and maxillary sinus (tau = -0.08-0.3).


CONCLUSIONS
MRI is a fast and reliable alternative to preoperative CT in examining paranasal sinuses and offers a good visualization of mucosal changes. CT and MRI both give an unreliable representation of the ethmoidal complex.
Weiss
F
F
Klinik und Poliklinik für Radiologie, Universitätsklinikum Hamburg-Eppendorf. F.Weiss@uke.uni-hamburg.de
Habermann
C R
CR
Welger
J
J
Knaape
A
A
Metternich
F
F
Steiner
P
P
Rozeh
B
B
Schoder
V
V
Bücheler
E
E
D016477:Artifacts; D002908:Chronic Disease; D015521:Ethmoid Sinusitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D015522:Frontal Sinusitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D015523:Maxillary Sinusitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D016684:Prone Position; D012852:Sinusitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D015524:Sphenoid Sinusitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D016683:Supine Position; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods