apuntes de radiologia rinosinusal iii parte
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8/4/2019 Apuntes de Radiologia Rinosinusal III Parte
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13/04/2012Seminarios Anatoma Clnico Radiolgica Tel.
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Apuntes de Fisiologa,
Anatoma-radiolgica-clnica
Seminarios Taller Presencial junio..2009Clnica de Asma y Alergia III.Parte
CT, MRI , Ultrasonido,
ImagenologaSinusitis Crnica otraspatologas
Lean las notas al pie de las diapositivas
NEW !
mailto:jhsdoctor@hotmail.commailto:jhsdoctor@hotmail.commailto:jhsdoctor@hotmail.com -
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RevisinDr. Juan Herrera SalazarClnica de Asma y Alergia
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Anatoma radiologicaCT Scan
Cortes axiales, Sagitales yReconstruccin coronal..
New !
Updated
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Dr. Juan Herrera Salazar
13/04/2012Seminarios Anatoma Clnico Radiolgica Tel.
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Foro Mdico Nicaragense
Portales Mdicos
Medbook
Mi blog de Asma y Alergia
http://colmedni.ning.com/profile/DrJuanHerreraSalazarhttp://colmedni.ning.com/profile/DrJuanHerreraSalazarhttp://www.medbook.es/profile/JuanHerreraSalazarhttp://drjuanherrerasalazarasmayalergia.blogspot.com/http://drjuanherrerasalazarasmayalergia.blogspot.com/http://www.medbook.es/profile/JuanHerreraSalazarhttp://colmedni.ning.com/profile/DrJuanHerreraSalazarhttp://colmedni.ning.com/profile/DrJuanHerreraSalazarhttp://colmedni.ning.com/profile/DrJuanHerreraSalazar -
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Bibliografa
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Atlas Netter II edicin.
Atlas Netter IV edicin Interactiva.
Atlas, Anatomy,Carmine de Clemente 3rd ed.. Gray s Anatomy Ed. Longman 1973.
Emedecine collection
Nasal Cavity Anatomy, Physiology, andAnomalies on CT Scan Author: Belachew Tessema,MD; Chief Editor: Arlen D Meyers, MD, MBA. Updated: Mar29, 2011
http://emedicine.medscape.com/article/875126-overviewhttp://emedicine.medscape.com/article/875126-overviewhttp://emedicine.medscape.com/article/875126-overviewhttp://emedicine.medscape.com/article/875126-overviewhttp://emedicine.medscape.com/article/875126-overview -
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Bibliografa Emedecine
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Nasal Physiology Author: Sanford M Archer, MD;Chief Editor: Arlen D Meyers, MD, MBA more...
Olfactory System Anatomy Author: Amir
Vokshoor, MD; Chief Editor: Arlen D Meyers, MD,MBA more...
Nasal Aerodynamics Author: Samuel J Lin, MD;Chief Editor: Arlen D Meyers, MD, MBA more...
Nasal Reconstruction Author: Ali Sajjadian, MD,FACS; Chief Editor: Arlen D Meyers, MD,MBA more...
http://emedicine.medscape.com/article/874771-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/874822-overviewhttp://emedicine.medscape.com/article/876456-overviewhttp://emedicine.medscape.com/article/876456-overviewhttp://emedicine.medscape.com/article/876456-overviewhttp://emedicine.medscape.com/article/874822-overviewhttp://emedicine.medscape.com/article/874822-overviewhttp://emedicine.medscape.com/article/874822-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/835585-overviewhttp://emedicine.medscape.com/article/874771-overviewhttp://emedicine.medscape.com/article/874771-overviewhttp://emedicine.medscape.com/article/874771-overview -
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Lo ms dificil es ver lo que esta delante de tus ojos W.Goethe
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Anatomia radiolgica
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Radiografa Craneo Rx. . Lateral
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Definicin de Sinusitis Sinusitis is an inflammation of the mucosal lining
of the paranasal sinuses. As the mucosa of thesinuses is continuous with that of the nose,rhinosinusitis is a more suitable term.[1, 2]
Sinusitis can be subdivided into acute, subacute,
and chronic disease. Acute sinusitis is defined asdisease lasting less than 1 month. Subacutedisease lasts 1-3 months, and chronic sinusitis
lasts longer than 3 months and is generallyrelated to suboptimally treated acute or subacutedisease. Acute and subacute sinusitis are treatedmedically, whereas chronic sinusitis may
require surgical intervention. 13/04/2012Seminarios Anatoma Clnico Radiolgica Tel.
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Radiografa de los Senos
Nasales
Waters(occipitomental)
Caldwell(occipitofrontal)
Vista Lateral
Vista basilar (submento-vrtice)
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Polypoid mucosal thickening in the right maxillarysinus with a mucous retention cyst in the left on aWaters view.
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CT Scan Metodo Preferido Computed tomography (CT)
scanning is the examination ofchoice in sinusitis, particularly incases of chronic sinus disease,providing excellent detail of sinusanatomy. However, CT is usually notuseful in acute sinusitis, asdiagnosis in acute cases is primarilybased on clinical findings. Goodanatomic definition is desirablebefore surgical intervention.
Coronal CT imaging is the preferredinitial procedure. Bone-window
views provide excellent resolutionand good definition of the completeostiomeatal complex and otheranatomic details that play a role insinusitis. In addition, the coronalview is best correlated with findings
from sinus surgery, with anatomyand pathology visualized in a plane
CT provides an excellent anatomic
display of soft-tissue attenuation.This depiction includes fluidlevels and polypoid masseswithin the normally air-filledcavities of the sinuses, nasalcavity, and postnasal space. Mostimportant, disease extendingbeyond the bony perimeters ofthe sinuses into the adjacent softtissue of the orbit,[7] brain, andinfratemporal fossa can beimaged.
In general, nonenhanced CT scans
suffice in cases of uncomplicatedsinusitis. Multisection CT seemsto have the potential to replaceprimary coronal CT of theparanasal sinuses without anyloss of image quality, and it may
even improve the overalldiagnostic value. However, the13/04/2012Seminarios Anatoma Clnico Radiolgica Tel.
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Tomografa Axial Computadorizada (TC) de
los senos paranasales
http://www.info-radiologie.ch/tomografia-senos-paranasales.phphttp://www.info-radiologie.ch/tomografia-senos-paranasales.phphttp://www.info-radiologie.ch/tomografia-senos-paranasales.phphttp://www.info-radiologie.ch/tomografia-senos-paranasales.php -
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Si desean msresolucinhagn clik
info-radiologie.ch
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CT Scan Anatomia y Fisiologa
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CT scan, nasal cavity.
Normal anteriorostiomeatal complexanatomy.
The anatomy of theethmoid infundibulum
and the uncinateprocess isdemonstrated here.
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CT Scan Anatomay Fisiologa
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The uncinate process(UP) and lateral wall ofthe nasal cavity form
the ethmoidinfundibulum (EI). Theabove sinuses drain intothe EI via various ostia.The maxillary sinusostia and the frontal
sinus recess or ductdrain into the anterior-most portion of theOMC and areconsistently identifiable
on CT scan. Normalfrontal recess/duct.Frontal sinus emptiesinto the middle meatus
just lateral to the moreanterior portion of the
middle turbinate. The
COMComplejo Osteo
Meatal
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Anatoma yFisiologa
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Stammberger andMesserklinger
Drainage
Normal posteriorostiomeatal
complex. The vomerseparates the twoostia into thesphenoid sinus.
These ostia arelocated in thesphenoethmoidrecess. The vomer is
normally
Complejo OsteoMeatal Posterior
Normal
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Anatoma yFisiologa
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A normal sagittalreconstruction of the
OMC, showing thecurved edge of the
semilunar hiatus withthe inferior mucosal
edge covering the UP,can be seen in theimage below. Thefrontal recess is alsoshown.
Complejo OsteoMeatal Posterior
Normal
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Anomalas de la Cavidad Nasal
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Fusion (apparent) ofuncinate process to theethmoid floor. Note thenormal uncinate
process on the otherside. Airway flow iscompromised from thesinuses to the middlemeatus because of the
functionally occludedsemilunar hiatus.Because the maxillarysinus is patent and
aerated, this is not a
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Anomalas de la Cavidad Nasal
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Congenital or truefusion of the uncinateprocess to the orbitfloor. The maxillarysinus is hypoplastic andnot aerated. Theethmoid infundibulumdoes not exist or endsblindly as the recessusterminalis.
The UP tip can also
fuse directly to thelateral wall or laminapapyracea of the orbit.This anomaly producesthe same imaging
findings as inferomedialfusion.
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Anomalas de la Cavidad Nasal
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Bilateral
pneumatization of
the uncinate tips.
Expansion of thetips can
compromise the
ethmoid
infundibulum, thesemilunar hiatus,
or the middle
meatus.
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Anomalas de la cavidad nasal
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Concha bullosa of the
left middle turbinatewith expansion and
narrowing of theethmoid infundibulumand the middlemeatus. Note
absence of the rightuncinate process,another anatomicvariant.
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Anomalas de la cavidad nasal
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Large Haller air cellclearly narrowing the
ethmoid infundibulum.
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Anomalas de la cavidad nasal
Overexpansion of theethmoid sinus floors
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Patrones radilogicos al CT
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Patrones radilogicos al CT
Scan
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Bilateral ethmoid
sinusitis on anMRI.
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Complejo Osteomeatal
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Mucosalthickening in
the left anteriorethmoid and
maxillarysinuses and inthe region of
theinfundibulum.This indicatesan ostiomeatal
pattern ofsinusitis
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Conca Bulosa
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Concha
bullosa ofthe rightmiddle
turbinate.
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Celdas de Haller
Paradoxical curves ofboth middle turbinatescause narrowing ofthe ostiomeatal units.
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Para los especialistas
Magnetic ResonanceImaging
Ultrasonography
Nuclear Imaging
Angiography
Sinusitis Imaging
Author: Rochita VRamanan, MBBS,MD, DNB, DMRD;Chief Editor: L GillNaul, MD
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http://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overviewhttp://emedicine.medscape.com/article/384649-overview -
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CT scan Spiral CT scan
1mm cuts
Magnetic ResonanceImaging
The exclusive use of coronal CT scansfor sinus imaging could result in thefailure to diagnose nasal cavityneoplasms. In the absence of bonedestruction, an esthesioneuroblastoma or
other neoplasm may be mistaken for anasal polyp on a CT scan, whereas onMRI, the nature of this tumor is quiteapparent. Beyond anatomic variants, anysuspicious findings should be imaged by
means of MRI.
Despite advances in MRItechnology, insufficient tissue, plusthe problems of susceptibility due tothe air-containing passages, makeMRI a less effective study for nasalcavity sinusitis problems, unless ofcourse the sinusitis turns out to berelated to squamous cell carcinoma(SCCa).
To date, no new MRI contrastagents that have an affiliation for
SCCa have been released.
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Gracias !
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Gracias por la oportunidad
Desde la Clnica de Asma y Alergia
Managua , Nicaragua. Tel 22781169, 22703359,88825513
Dr. Juan Herrera Salazar
Favor ver la II Parte
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