X-rays of the paranasal sinuses are performed in 2 projections: nasomental and chin. Each X-ray image allows you to visualize specific anatomical structures.
Due to the many nuances and subtleties during installation, the attending physician’s prescription must be analyzed by a radiologist before performing an x-ray. The specialist may prescribe a different projection or cancel the attending physician’s prescription.
What is visible on an x-ray of the paranasal sinuses (SNS) in the frontal projection
The paranasal sinuses in the frontal projection shows the following anatomical structures:
- Lattice labyrinth (photo by Reza).
- Right and left halves of the sphenoid sinuses.
Obviously, it is impossible to determine sinusitis with such radiography. This is true, therefore the frontal projection is rarely used when studying pneumatization of the PPN.
What does a X-ray of the PPN in the chin projection show?
The chin projection is the most preferable when examining for sinusitis. She shows the sinuses as openly as possible. When using the nasochin pyramid placement temporal bones the maxillary sinuses overlap the area in the lower third and make it difficult to clearly view them throughout.
Setup for radiography of the paranasal sinuses If performed poorly in the nasomental projection, the pyramids of the temporal bones can almost completely block the view.
To level out the defect described above, the patient is often asked to open his mouth. With this arrangement, the temporal bones are lowered downwards. The beam can also be directed vertically at an angle of 30 degrees to the vertical (according to Chebull). On such radiographs, you can clearly trace the condition of the sinuses of the sphenoid bones.
If the projections described above are not enough, X-rays of the PPN can be supplemented by tomographic examination or maxillary sinusography. Tomography is a layer-by-layer study. It allows you to study the anatomical structures that lie deep in the tissues.
Maxillography is the introduction of a contrast agent into the paranasal sinuses. The method is often used when a ring-shaped shadow resembling a cyst is detected.
How is the examination of the paranasal sinuses performed?
Examination of the paranasal sinuses in the chin projection can be carried out in a vertical or horizontal (lying) position of the patient. Most often during the procedure, the person sits or stands near a vertical x-ray stand. This placement allows you to get the optimal shot if sinusitis is suspected.
How to do a PPN x-ray:
- The patient stands along a stand with a fixed grid.
- His head is positioned so that his chin touches the stand and his nose is 2 cm away from it.
- The midline of the head is located sagittally.
- The exposure is made on a 13 by 18 cassette.
- Focal length - 100 cm.
An X-ray of the paranasal sinuses with a contrast agent allows you to fully study the structure of these anatomical formations and identify additional (“plus shadows”) that can be formed by cysts, polyps and tumors.
How to evaluate the quality of an image when examining the paranasal sinuses
A high-quality radiograph of the paranasal sinuses does not show additional shadows (artifacts). The anatomical structures are symmetrical and clearly visible.
With sinusitis, the fluid level is visualized, located from the medial to the lateral wall. Chronic inflammatory processes in the PPN (hypertrophic) are accompanied by thickening of the mucous membrane with a concave outer contour (like a parabolic curve).
Scheme from an X-ray of the skull in a nasofrontal projection To distinguish an acute process from a chronic one, it is advisable to shift the patient’s head to the left or right during repeated examination. If the inflammatory process is “fresh”, the fluid level will shift.
With chronic changes, the X-ray symptoms of the pathology will not change.
Criteria for assessing image quality:
- clear structure of bone walls;
- symmetry of installation;
- the presence of white-gray shadows (determines the technical features of the exposure).
Maxillography - contrast study
Maxillaryography allows you to identify intra-axillary formations. It is also used to diagnose polyps or cysts.
How is sinusography performed:
- After anesthesia, a puncture of the sinus wall is performed.
- Through it, the PPN is washed with a solution of furatsilin.
- Then a solution of heated iodolipol is injected using a needle.
- The patient is taken pictures in the nasofrontal, nasomental and lateral projections.
Attention! When doing maxillary sinusography, you cannot take x-rays of both at the same time. maxillary sinuses. In this situation, the possibility of clear visualization of anatomical structures is excluded due to overlapping exposure from the other sinus.
X-ray of the posterior nasal cavities
The posterior paranasal sinuses include the following anatomical structures:
- wedge-shaped;
- lattice cells.
The nasomental and submental projections are not suitable for studying these anatomical structures. Axial projection is used here. The rocky part of the temporal bone, foramina of the base of the skull, and skull fractures can also be seen using this projection.
The sphenoid bone has big variety buildings. The radiologist must have extensive experience to interpret correctly. The x-ray image in the axial projection of the rosary shows the wings of the sphenoid bone and the basilar apophyses.
In this projection, the openings are clearly visible: round, oval and posterior torn. For skull injuries (falling on the head, blows to occipital bone and crown) a fracture line appears. On examination, fracture lines and lower jaw, as well as the base of the apophysis of the occipital bone.
If pathology is detected in one of these anatomical structures, X-rays can be supplemented with targeted radiographs for clearer visualization.
In conclusion, I would like to say that x-rays of the skull and paranasal sinuses belong to one of the most complex areas of radiology. Due to the multitude of formations, very often on an x-ray you can see symptoms formed by the overlap and superposition of various anatomical details. Large required practical experience to distinguish normal from pathology in photographs of the paranasal sinuses and skull.
Radiography as a method radiology diagnostics, is widely used in many areas of medicine, including otolaryngology. The examination is carried out without damaging the upper tissues, that is, non-invasive, does not take much time, and is painless.
X-ray of the nose and paranasal space allows you to reliably determine existing changes in bone structures and pathology of the air cavities (sinuses). Clear visualization of organs on an x-ray allows the doctor to objectively assess their condition, make the correct diagnosis, and prescribe appropriate treatment. According to the decision of the ENT doctor, a survey or targeted radiography is performed:
- survey X-ray, depicts the bones of the nose and sinuses as a whole, and is most often performed when primary diagnosis;
- targeted radiograph to examine individual anatomical structures in more detail. It is carried out to monitor the treatment of a previously diagnosed disease of a particular nasal area.
How often can you do it this procedure? The frequency of examination has not been officially established. The dose of X-rays during a single examination is not dangerous to health, but taking into account the fact that radiation tends to accumulate in the body, X-rays of the nasal sinuses are not recommended more than twice a year.
Survey area
The picture is taken in black and white, which clearly shows the bone skeleton of the nose, the size of the nasopharynx, the structure and contours of the air cavities (aka sinuses). Using the image, the doctor analyzes the integrity of the bones and cartilage tissue, the state of hollow formations adjacent to the nose:
- frontal (frontal) sinuses, located in the frontal bone of the skull;
- lattice labyrinth;
- the main sphenoid sinus, divided by a septum;
- paired maxillary (maxillary) cavities;
- the lower part of the temporal bones with a cellular structure (mastoid process).
According to the norm, in the absence of pathologies, the outline of the bones should be smooth, the pneumatization (airiness) of the sinuses should not be impaired, that is, there should be no neoplasms or fluid or foreign objects
Abnormalities and diseases diagnosed from the image
One of the main diseases of the nasal cavities is sinusitis (inflammation of the mucous membranes), has several various forms. X-ray paranasal sinuses nose allows you to identify sinusitis. Sinus hyperplasia or hyperplastic sinusitis is characterized by increased growth mucosal cells. This area will appear thicker in the image. Catarrhal, edematous-catarrhal or exudative (with accumulation of fluid) form of sinusitis is displayed on an x-ray as a sharp darkening of the inflamed sinus. Allergic sinusitis is manifested by severe swelling.
X-ray of the paranasal sinuses differentiates the disease by location:
- inflammation maxillary sinuses– sinusitis;
- inflammation of the frontal sinus - frontal sinusitis;
- pathology of the mastoid processes – ethmoiditis.
The scale of distribution is also determined inflammatory process. With monosinusitis, the disease affects only one paranasal cavity; polysinusitis is diagnosed when inflammation is localized in several sinuses. If all right or all left sinuses are involved in the process, a diagnosis of hemisinusitis is made; damage to all cavities means the presence of pansinusitis.
Other pathologies
If an x-ray shows the presence of a round cavity with a clear outline in the sinus, this is a sign of a cyst. Less commonly, other neoplasms are diagnosed. A foreign object that has entered the sinuses will also appear on the image. Unevenly located, dark on x-ray, parietal areas indicate the presence of polyps (abnormal growths).
A photo of an x-ray of the nose with a diagnosis of polyposis clarifies the localization of the formation
In children, using an X-ray examination of the nose and adjacent spaces, an inflammatory increase in the lymph tissue of the nasopharyngeal tonsil - adenoiditis - is diagnosed, as well as the degree of development of the disease. With first degree adenoids, they occupy 1/3 of the nasopharyngeal lumen, the second degree is characterized by damage to ½ of the lumen, third degree adenoids completely block the lumen of the nasopharynx.
To diagnose tumors of benign and malignant origin, experts recommend undergoing an MRI or CT scan of the nasal sinuses, since these methods are more informative in detecting such pathologies.
Diagnostics of cartilage and bone tissue of the nose
X-rays of the nasal bones are always prescribed for bruises and other injuries. Moreover, the more quickly it is done after a nose injury, the more reliable the results are. In the image, the radiologist determines:
- possible common nasal fracture;
- comminuted fracture, and the presence of fragments in soft structures;
- fracture with displacement, and the degree of bone displacement.
Interpretation of the radiograph also involves determining the curvature of the nasal septum, any other transformations and destructive destruction of the bone and cartilaginous components of the organ.
Purpose of the examination
X-ray of the paranasal sinuses (PSN) is indicated for the following symptoms and complaints presented by the patient:
- violation respiratory process due to chronic nasal congestion;
- the presence of pus and blood in the discharge;
- regular headaches, accompanied by a runny nose, not associated with other diseases (hypertension, VSD, etc.);
- pain in the central frontal region when bending over;
- pain when touching the nose;
- post-traumatic pain and swelling of the bridge of the nose;
- suspicion of the presence of a foreign object in the nose.
The listed symptoms are most often accompanied by hyperthermia (increased body temperature), fatigue, a feeling of heaviness in the head. X-rays of the nose and adjacent cavities are done to monitor the treatment of previously diagnosed diseases: sinusitis, sinusitis, frontal sinusitis, fracture and displacement of bones, polyposis and cysts. And also when specific diseases skeletal system organism, such as osteomyelitis, osteoporosis.
The picture must be taken before the planned sinus surgery and after surgical intervention
In some cases, the doctor may prescribe additional computed tomography paranasal sinuses. This decision is made if the image does not reveal pathological changes, but there is no positive dynamics in the patient’s condition, a neoplasm is visualized on the x-ray, but it is impossible to determine its nature, indications for surgery require more deep research nasal area.
The CT scan procedure takes longer and is expensive, but the 3D image gives a clearer picture of the anatomical changes and diseases present.
Contraindications
The examination is not prescribed during pregnancy, since X-rays have a teratogenic effect (impaired embryo development). Relative (relative) contraindications are:
- metal-plastic dentures. Metal parts may affect the quality of the picture.
- childhood. The child is given an x-ray only if emergency. At the same time, other parts of the body during the procedure must be protected with a special apron containing lead.
Safe MR imaging is recommended for diagnosis in young patients.
X-ray procedure
There are no preparatory activities for the examination. The patient only needs to choose where to take an x-ray: in a district clinic or a paid diagnostic center. Most often, the procedure is performed with the person being examined in an upright position. A special support is placed under the chin. The patient’s responsibility is not to close his mouth during the procedure and to hold his breath. The whole process takes half a minute.
To diagnose bone damage, photographs are taken in frontal projection and lateral (left and right). Additionally, shooting can be done in the nasal-chin projection. PPNs are examined in the occipitomental, erect, occipitofrontal, lateral and chin projections. The exact position in which the image will be taken depends on the diagnosis assumed by the otolaryngologist. Description of the image by a radiologist takes about a quarter of an hour.
Maxillaryography
X-rays of the maxillary sinuses in cases of complicated sinusitis are performed using a contrast agent. Maxillography is performed as prescribed by a doctor, and only for adult patients. The methodology includes:
- application local anesthesia;
- puncture of the sinus wall;
- cavity rinsing;
- injection of contrast into the studied sinuses;
- taking sequential photographs in several projections.
A photograph from an x-ray of the paranasal sinuses with a diagnosis of sinusitis clarifies the degree of filling of the sinus with contents
Removal of the contrast agent occurs spontaneously within 24 hours after the examination. Special attention this disease and its diagnosis is given due to the danger severe complications. Untimely detected sinusitis develops into chronic stage, in which the development of inflammatory processes in bronchopulmonary system and the brain.
Digital X-ray
Digital X-ray The graphic method of studying PPN is more progressive and informative. Images of the nasal cavities are projected onto a computer, which allows a more detailed study of the changes and pathologies of the organ. In addition, it is possible to save the results in digital form and transmit them, if necessary, via the Internet. The disadvantages of digital diagnostics include the cost of the examination.
For example, in the Moscow district of Brateevo, the price of such a procedure is from one and a half thousand rubles, as opposed to a regular x-ray for 250 rubles. There's no need to be afraid radiation exposure and ignore the assigned x-ray procedure. The image will help the doctor determine the only correct treatment tactics for the identified disease.
Content
To diagnose inflammatory processes, in most cases, radiography of the paranasal sinuses is used. It is prescribed for the purpose of identifying various pathologies and inflammatory diseases arising in this facial area. Learn about the features of this procedure and the problems it detects.
What is radiography of the paranasal sinuses?
To detect the inflammatory process, radiography is often prescribed. Discover a variety dangerous diseases on initial stage Development will be helped by x-rays of the sinuses. This procedure is very simple, painless and does not take much time. Often, this technique makes it possible to detect swelling and fluid in the paranasal sinuses, the presence of neoplasms (cysts, tumors), defects in the structure of the facial skeleton, damage, and injuries of various kinds.
Indications for the purpose of the study
X-ray of the nose is an effective digital technique through which you can quickly obtain the necessary information about the pathology of the olfactory organ or paranasal cavities. X-rays are performed for the following indications:
- Regular nosebleeds that appear for no apparent reason.
- Closed or open injury to the nasal bones or facial skull.
- Possibility of sinusitis (with symptoms: rhinitis, headaches, heat, labored breathing).
- Another prerequisite for x-rays of the sinuses is the suspicion of the presence of polyps, adenoids, cysts, tumors, and foreign objects.
- Assessing the progress of the treatment process.
- Preparatory activities to surgery.
Contraindications to the procedure
X-ray of the paranasal sinuses has several contraindications. It should not be given to pregnant women and children under seven years of age. The procedure is harmless and has low radiation exposure, but it is contraindicated for expectant mothers due to the strong sensitivity of the fetus to such research. X-rays during pregnancy can cause birth defects in the baby.
X-rays of the sinuses may be prescribed extremely rarely for preschoolers, because gamma rays can negatively affect the growth of the child’s bones. In isolated cases, the doctor issues a referral for radiography for children under 7 years of age and pregnant women (if the study becomes an alternative to the probable harm that the diagnosed disease may cause).
How often can an x-ray of the sinuses be taken?
Many people are interested in how often it is allowed to take x-rays of the paranasal sinuses. After any examination performed using gamma rays, outpatient card the patient is supplemented with a record of the radiation exposure value. If it turns out that these examinations were carried out too often, the doctor may prohibit a repeat procedure. There is a caveat: X-ray of the nose has a very low radiation dose, so this activity is performed as many times as necessary to make a diagnosis.
How is diagnostics carried out?
X-ray of the maxillary sinuses is performed simply and quickly, without special training. Diagnostics is carried out in outpatient setting. The patient must remove all metal products from himself. A person enters a special room where the research will be carried out. He needs to take a specific pose, which directly depends on the projection of the future photo. As a rule, the procedure is performed in two projections: occipitomental and occipitofrontal. An X-ray of the nose is done while standing, while holding your breath. The photograph is developed, dried and studied.
Decoding the testimony
In the photographs taken after diagnostic measure, the doctor can detect various types of inflammation, tumors, foreign bodies in the sinuses, cysts, deviated nasal septum, developmental defects and the location of injured facial bones. Radiography can also be used by doctors to diagnose sinusitis, an inflammatory process that affects the mucous membrane of the paranasal sinuses.
When pathology is detected in the sinus upper jaw, then they diagnose sinusitis, other areas - ethmoiditis, frontal sinusitis, sphenoiditis. If pathology is detected in time, there is a chance to avoid development serious complications(up to inflammation meninges). The doctor makes all changes that the x-ray shows medical report, with which the patient is referred to the necessary specialist.
Where and how much does a sinus x-ray cost?
Examination of the nose and its parts can be done in a public or private paid medical office Moscow, St. Petersburg and other cities of the country. Below is the approximate price x-ray examination, which depends on the specific clinic:
- X-ray of the paranasal sinuses (one projection) – from 1300 rubles.
- X-ray of the nasal sinuses (2 projections) – from 1,700 rubles.
X-ray of the paranasal sinuses- radiographic method for studying the paranasal sinuses. An x-ray of the sinuses allows you to evaluate the presence of inflammation, fluid, as well as fractures and displacement of the nasal bones.
In what cases is it required? An x-ray of the paranasal sinuses is performed to diagnose the presence of foreign bodies, cysts, tumors, bone injuries, delayed teeth growth, fractures of facial bones, absence and underdevelopment of the sinuses, inflammation of the paranasal sinuses.
Procedure. X-ray of the nose does not require special preparation. Contraindications: pregnancy, breastfeeding, open pneumothorax, pulmonary hemorrhage. When taking an x-ray, the patient rests on his chin and must keep his mouth open during the X-ray.
Price. average cost X-ray of the paranasal sinuses: 1200 rub.
Questions and answers:
Where to get an x-ray of the paranasal sinuses in Moscow?
The website DocDoc.ru contains best clinics Moscow, where they hold diagnostic test X-ray of the paranasal sinuses. Choose a center for this procedure directly on our website based on criteria that are important to you: location of the center, price, work schedule.
How much does an x-ray of the paranasal sinuses cost?
Prices for x-rays of the paranasal sinuses depend on many factors, primarily on the quality of the equipment and the location diagnostic center. On DocDoc.ru you will find the best centers in Moscow, which you can sort by cost of the procedure. The questionnaire for each center contains information about its work schedule, and also contains a telephone number where you can immediately sign up for a study.
We found 218 clinics where you can undergo x-rays of the paranasal sinuses in Moscow.
How much does a PPN x-ray cost in Moscow?
Prices for x-rays of the paranasal sinuses in Moscow from 800 rubles. up to 11731 rub..
X-ray of the paranasal sinuses: reviews
Patients left 5,901 reviews of clinics that offer X-ray PPN.
What is the essence of the study?
X-rays of the paranasal sinuses are taken in patients with obvious nasal pathology to exclude or detect accompanying illnesses paranasal sinuses - sinusitis. The sinuses, or sinuses, are paired air-filled pouches that surround the nose. The functions of the sinuses include humidifying the air inhaled through the nose, insulating the brain, and providing tone during voice production.
There are four pairs of sinuses:
- The frontal sinuses are located near the center of your forehead just above each eye.
- The maxillary sinuses are located behind the cheekbones, near the upper jaw.
- Sphenoid sinuses, approx. optic nerves and pituitary gland.
- Ethmoidal sinuses - between the eyes and the bridge of the nose.
Normally, the sinuses are filled with air, so they will appear black on x-rays of healthy sinuses. A gray or white area on an x-ray indicates a problem related to inflammation or fluid accumulation in the sinuses, such as sinusitis.
What does it show? What diseases does it diagnose?
Radiography is prescribed when probable symptoms sinus infections. Sinusitis occurs when the sinuses become inflamed and pus and mucus accumulate. Acute sinusitis Caused by viral, fungal and bacterial infections.
Symptoms of sinusitis include:
- stuffy nose with thick discharge,
- pain or heaviness in the forehead, between the eyes, cheekbones or upper jaw,
- swelling around the eyes, nose or cheeks,
- decreased sense of smell,
- cough, sore throat, ear pain,
- fever.
Sinus problems can also be caused by:
- allergies,
- tumors or polyps in the nasal passages or sinuses,
- enlarged adenoids,
- injuries,
- infections in other areas of the head,
- curvature of the nasal septum.
How is the research conducted?
X-rays of the sinuses can be performed on an outpatient basis or during hospitalization in the ENT department. The patient is placed or seated on the x-ray table. The radiologist then covers the subject's body with a lead apron to protect against radiation. The head is placed under the X-ray tube. The radiologist will then go into the next room to take the image. You should remain as still as possible during the x-ray. Otherwise the image will be blurry. It only takes a couple of seconds to complete the x-ray image. You may hear a click, similar to the sound a camera makes when shooting. The doctor may reposition the patient several times to obtain images of all sinuses. Typically, images are taken in three projections: lateral view, occipito-frontal and axial view.
Contraindications and restrictions
Pregnant women are prohibited from taking x-rays.
Preparing for the study
X-ray examination does not require special preparation. Women should be sure that they are not pregnant. It is necessary to remove jewelry, removable metal dentures, hair clips, earrings and glasses.
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