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Incidental paranasal sinus abnormalities on MRI of the brain
F G Moser1, D Panush, J S Rubin
1Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
Abstract:
T2-weighted magnetic resonance imaging (MRI) presents paranasal sinus pathology with remarkable clarity. However, it has yet to be demonstrated that all MRI findings represent true pathology and not minor or incidental findings of no consequence. In an effort to resolve this question, we have analysed retrospectively 263 consecutive T2-weighted MRI examinations of the head performed for indications not associated with possible sinus pathology. We examined these studies for abnormally increased signal in the paranasal sinuses and the sites of involvement. Mucoperiosteal thickening, mucus retention cysts, air-fluid levels or total sinus opacification were recorded. Of the 263 studies examined, 65 (24.7%) demonstrated abnormalities in the paranasal sinuses. We conclude that because of its great sensitivity MRI will often detect abnormalities in the paranasal sinuses which are unrelated to the patients' presenting problems.
Insights
T2-weighted magnetic resonance imaging (MRI) is sensitive for detecting paranasal sinus abnormalities. Many findings on MRI scans are incidental and not true pathology, unrelated to the patient's symptoms.
Area of Science:
- Radiology
- Medical Imaging
Background:
- T2-weighted MRI offers high clarity for paranasal sinus pathology.
- The clinical significance of all MRI findings requires further investigation.
Purpose of the Study:
- To determine the frequency of incidental paranasal sinus abnormalities on T2-weighted MRI.
- To differentiate true pathology from incidental findings in paranasal sinuses.
Main Methods:
- Retrospective analysis of 263 T2-weighted head MRI examinations.
- Studies were selected for indications unrelated to sinus pathology.
- Abnormalities such as thickening, cysts, fluid, and opacification were recorded.
Main Results:
- 24.7% of the analyzed MRI studies showed paranasal sinus abnormalities.
- Findings included mucoperiosteal thickening, mucus retention cysts, air-fluid levels, and opacification.
- These abnormalities were often incidental and unrelated to the primary indication for the scan.
Conclusions:
- High sensitivity of MRI can lead to detection of asymptomatic paranasal sinus abnormalities.
- Many MRI findings in the paranasal sinuses may represent incidental findings rather than significant pathology.