Diagnostic Radiological Imaging of Intracranial Complications of Sinusitis using CT Scan and MRI

Abstract

Background and Objectives: In the context of paranasal sinusitis, intracranial
complications, though infrequent in the antibiotic era, can prove fatal. A substantial
percentage of individuals may experience such complications, with a considerable fatality
rate, often attributable to delayed disease diagnosis. Our study sought to evaluate the
contribution of radiological diagnostics for the measurement and determination of the optimal
timing for surgical intervention in patients with sinusitis complicated by intracranial issues.
Methodology: This study encompassed 50 patients diagnosed with chronic sinusitis
accompanied by intracranial complications. Radiological examinations, including CT scans
and MRI scans of the brain and paranasal sinuse, were performed. Results: CT and MRI
scans were pivotal in detecting characteristic features indicative of infectious sinusitis,
encompassing mucosal thickening, opacification of sinus cavities, soft tissue changes, and
bone erosion. MRI emerged as the preferred imaging modality for delineating soft tissue
involvement and discerning nuances in signal intensity, crucial for identifying necrotic tissue
or extra cranial extension. Key imaging findings included mucosal thickening and variable
signal intensities indicative of fungal masses in T1 as well as T2-weighted images, alongside
contrast-enhanced MRI revealing patterns suggestive of tissue invasion. Conclusions: While
CT is highly effective in imaging bone structures, the judicious use of MRI and Magnetic
Resonance Venography (MRV), guided by clinical history and examination findings, is
advisable to definitively exclude intracranial extension in cases of sinusitis.