MRI for Sinusitis

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MRI for Sinusitis

We often get this question from patients – why do I need an MRI for sinusitis? MRI is often associated with more serious health conditions and perceived as an expensive diagnostic tool leading to this confusion. We will attempt to throw light on this topic and clear any misunderstandings about the application of MRI for Sinusitis.

MRI technology has pushed the standards of diagnostics up by a few bars. Up to this day, MRI is the imaging modality that provides the most information about patients’ inner anatomical relations. Using unique presets and intravenous contrast, doctors can reconstruct – in 2D & 3D – all structures inside the body. All the data gathered can be later used in computer-assisted surgery.

By detecting not only anatomical features of organs, but their function(s) as well, the novel technology of functional MRI (fMRI) revolutionized the way doctors today understand, study and treat the human body.
There is no sphere of medicine which doesn’t benefit from MRI and ENT, specifically Sinus treatment is no exception. fMRI is particularly useful in diagnosing sinusitis and diseases that might cause repetitive Sinusitis episodes.

Diagnosing Sinusitis with MRI

The crucial question every ENT specialist tries to answer when treating Sinusitis is ’What lies behind this episode of Sinusitis?’ In most cases, the reason is just a respiratory infection which happened to spread to the paranasal sinuses, but sometimes the explanation might surprise both the patient and doctor.

Many benign and malignant diseases remain silent for a long time, causing only mild problems such as occasional Sinusitis episodes or nasal congestion. Diagnosing those conditions in time is crucial for a better outcome of the treatment.

MRI vs CT Scan vs X-ray in ENT

Conventional radiography (X-ray) has not a single advantage over MRI examination. The only reason it’s still in use is because the exam is quick and cheap.

The answer to which one between MRI and CT scan is better is not that straightforward. MRI outperforms CT scan in just a handful of conditions. The most important are sinus tumors evaluation and fungal infections of sinuses (both quite rare pathologic entities). Generally speaking, a CT scan provides a better view of the bony structures, while MRI generates more data about soft tissues.

As for all other changes in the region of paranasal sinuses, MRI shows no advantages over CT scan.
The fact that MRI doesn’t use X-rays comes particularly handy in pregnant women (unlike CT and conventional radiography, MRI examination can be safely performed in pregnancy and children.

The reason some people can’t undergo MRI

Metal prosthetic implants

Patients with metal prosthetic implants cannot undergo MRI. The magnetic field inside the MRI machine is so strong, it would pull out any metal part from the body. Luckily, most of the prosthetic implants today are made of non-magnetic materials.

Allergy to contrast

To make specific compartments and blood vessels of the body more visible, doctors sometimes use contrast agents(these are dyes injected into the body to highlight certain areas). People allergic to those can’t undergo the examination. However, MRI without contrast is still available to them.

Patients with kidney failure

Although safe, the contrast agent might interfere with kidney function if it’s already impaired (kidney failure). Therefore, MRI with contrast is rarely carried out for those patients. MRI without contrast is available to them.

The Limitations of using MRI for Sinusitis diagnosis

MRI is an almost perfect diagnostic tool. With just a handful of absolute contraindications, it is a safe and reliable imaging method. However, it would be fair to say that at least in the pathology of paranasal sinuses, it outperforms CT scan in only a couple of diseases. The limitations are its price and the time needed for an examination.

MRI is a powerful diagnostic tool for ENT specialists and specifically Sinus experts. Unfortunately, not everyone can afford it as top notch systems cost a hefty INR 4 Crore+. The price is the biggest reason for MRI’s limited availability. Unlike conventional radiography that takes seconds and CT scan that takes minutes, MRI examination usually lasts 15 or more minutes.

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Medically reviewed by SinusDoctor,
Dr G V K Chaitanya Rao

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