Paranasal sinuses in pediatric patients by MRI: normal development and preliminary findings in disease

A two-part study using medium field strength magnetic resonance imaging (MRI) was designed to describe the normal paranasal sinus development and to provide preliminary criteria for clinical sinus disease. In part I of the study the paranasal sinuses were retrospectively evaluated in 80 infants and children aged 0-17 years undergoing brain MRI for indications both unrelated and related to sinus disease. We developed MRI criteria for independent grading of paranasal sinus development and 'anatomical' sinus disease, i.e., disease as seen by the radiologist. We quantified the variability in extent of sinus pneumatization (a measure of sinus development) in infants and young children. Part II of the study was a double-blind prospective study in 21 patients to correlate 'anatomical' disease with 'clinical' sinus disease. In this limited preliminary study, clinical sinus disease was only seen in the patients with moderate or severe anatomical disease (sensitivity 100%; specificity 100%).