X-ray of the sinuses: indications, contraindications, interpretation of the results. Examination of the sinuses with an x-ray and how often it can be done Take an x-ray of the maxillary sinuses

X-ray of the paranasal sinuses(PPN) is a necessary component of a comprehensive clinical examination of patients in otorhinolaryngological departments. In medical practice, an x-ray of the nose is performed using radiography, fluoroscopy and linear tomography. The nasal cavity is located in the central part of the facial skull and is divided in half by a septum. Near it are paired paranasal or paranasal sinuses, which communicate with the nasal cavity through passages (channels). Under natural conditions, the sinuses are filled with air, and therefore the X-ray of the PPN shows them well as light, clearly defined formations.

As a rule, radiography of the paranasal sinuses is performed with the introduction of radiopaque preparations into their cavity or into the vein of the patient, and also in the standard version - without artificial contrast. The sinuses are filled with contrast agents during probing of their anastomoses, during puncture, or with the help of sinus catheters. To get a picture of the paranasal sinuses, it is enough to inject 3-5 ml of a radiopaque agent into the cavity. After that, it becomes possible to determine the size of the cavity and the presence of filling defects due to volumetric formations using the radiograph.

Since sinusitis is very common among ENT pathologies, most often otorhinolaryngologists prescribe an x-ray of the frontal sinuses and an x-ray of the maxillary sinuses. Inflammatory processes in these sinuses (as well as in the ethmoid and sphenoid sinuses) are the cause of hospitalization of 30-40% of all patients referred to the ENT hospital. High-quality radiography of PPN is provided by conducting a study in special projections: nasolabial, chin or naso-chin. The naso-chin is done in a vertical position of the patient (standing, sitting), the chin is done while sitting with the chin touching the cassette, and the naso-frontal is done with the forehead and tip of the nose touching the cassette.

The x-ray of the nose is done in the x-ray room. The essence of the upcoming manipulations is explained to the patient in advance. If the x-ray of the nose is performed with contrast, the patient is warned about the possible sensations of fullness in the nasal cavity. Before the study, the presence of allergic reactions and hypersensitivity to the pharmaceuticals used is necessarily clarified. If necessary, anesthesia of the nasal mucosa is performed using an aerosol or application method. X-rays of the sinuses are difficult to make for mobile, excitable individuals and young children. In such situations, measures are taken to keep the patient in the desired position or anesthesia is administered to him.

X-ray of the sinuses is prescribed mainly by an ENT doctor, surgeon, therapist or oncologist and serves to identify:

• traumatic injuries and foreign bodies of the sinuses;
• acute and chronic sinusitis;
• sinusitis;
• odontogenic tumors and cysts;
• osteom, chondroma, angiofibroma;
• cancer and sarcoma;
• granulomatous inflammation (tuberculosis, Wegener's granulomatosis);
• mucocele;
• polyps of the nasal cavity;
• thickenings, deformations, perforations of bone walls and partitions.

In clinical practice, x-rays of the sinuses are used both for diagnostic purposes and to monitor the effectiveness of therapeutic measures and postoperative rehabilitation.

You can take a picture of the sinuses in most medical centers. Using this online service, you can easily find a diagnostic department that meets the parameters you need (city area, distance from the metro station, type of examination). On the pages of the site you will receive information not only about the location of the selected medical institution, but also about its work schedule and pricing policy. The site provides a free service for recording an x-ray of the paranasal sinuses in the selected clinic. To get an appointment at a convenient time for you, you just need to fill out an online application or contact the Call Center of the site.

Content

For the diagnosis of inflammatory processes in most cases, radiography of the paranasal sinuses is used. It is prescribed to identify various pathologies and inflammatory diseases that occur in this facial area. Learn about the features of this procedure and the problems it detects.

What is an x-ray of the paranasal sinuses

To detect the inflammatory process, radiography is often prescribed. An x-ray of the sinuses will help to detect a variety of dangerous diseases at the initial stage of development. This procedure is very simple, painless and does not take much time. Often this technique allows you to detect swelling and fluid in the paranasal sinuses, the presence of neoplasms in them (cyst, tumor), flaws in the structure of the facial skeleton, damage, injuries of various kinds.

Indications for the appointment 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. Radiography is performed for the following indications:

1. Regular nosebleeds that appear for no apparent reason.
2. Closed or open trauma to the nasal bones or facial skull.
3. Chance of sinusitis (with symptoms: rhinitis, headaches, high fever, difficulty breathing).
4. Another prerequisite for x-rays of the sinuses is the suspicion of the presence of polyps, adenoids, cysts, tumors, foreign objects.
5. Evaluation of the progress of the treatment process.
6. Preparatory measures for surgical intervention.

Contraindications to the procedure

X-ray of the paranasal sinuses has several contraindications. It should not be done to pregnant women and children under the age of seven. The procedure is harmless and is characterized by low radiation exposure, but it is contraindicated for expectant mothers due to the strong sensitivity of the fetus to such a study. X-rays during pregnancy can cause birth defects in the baby.

For preschoolers, sinus x-rays may be extremely rare, because gamma rays can negatively affect the growth of the child's bones. In isolated cases, the doctor issues a referral for x-rays to children under 7 years of age and pregnant women (if the study becomes an alternative to the likely harm that the diagnosed disease can cause).

How often can x-rays of the sinuses be taken?

Many are interested in how often it is allowed to undergo an x-ray of the paranasal sinuses. After any examination performed with the help of gamma rays, the patient's outpatient card is supplemented with a record of the value of radiation exposure. If it turns out that these examinations were carried out too often, the doctor may prohibit a second procedure. There is a nuance: the radiography of the nose has a very low dosage of radiation, so this event is performed as many times as necessary to make a diagnosis.

How is the diagnosis carried out

X-ray of the maxillary sinuses is performed simply and quickly, without special training. Diagnosis is carried out on an outpatient basis. The patient must remove all metal products from himself. A person enters a special room where the study will be carried out. He needs to take a specific pose, which directly depends on the projection of the future image. As a rule, the procedure is performed in two projections: occipital-chin and occipital-frontal. X-ray of the nose is done while standing, holding the breath. The picture is developed, dried and studied.

Interpretation of indications

On the pictures taken after the diagnostic event, the doctor can detect various kinds of inflammation, tumors, foreign bodies in the sinuses, cysts, deviated nasal septum, developmental defects and the location of the injured facial bones. Even radiography can be used by physicians to diagnose sinusitis - an inflammatory process that affects the mucous membrane of the paranasal sinuses.

When the pathology is detected in the sinus of the upper jaw, then they make a diagnosis of sinusitis, other areas - ethmoiditis, frontal sinusitis, sphenoiditis. If pathology is detected in time, then there is a chance to avoid the development of serious complications (up to inflammation of the meninges). All modifications that the radiograph shows, the doctor makes a medical report, with which the patient is referred to the necessary specialist.

Where to do and how much does an x-ray of the nasal sinuses cost

Examination of the nose and its parts can be done in a public or private paid medical office in Moscow, St. Petersburg and other cities of the country. Below is the approximate price of an X-ray examination, which depends on the specific clinic:

1. X-ray of the paranasal sinuses (one projection) - from 1300 rubles.
2. X-ray of the nasal sinuses (2 projections) - from 1700 rubles.

Many people suffer from various diseases associated with the sinuses. The fact is that a lot of processes associated with viral diseases take place in them, various neoplasms can also appear there and many violations occur. For this reason, the x-ray of the sinuses is a very important diagnostic procedure that must be performed in many diseases, especially sinusitis. This method of examination is primarily aimed at identifying deviations from the normal state of the sinuses, as well as identifying infectious diseases and pathological processes. X-ray of the sinuses with sinusitis, the photo of which you can see below, is able to determine the degree of damage and changes in the mucous membranes, as well as tumors and cysts.

A picture of the sinuses has sufficient information to determine the disease.

It is worth noting that this kind of X-ray examination is very different from computed tomography and MRI diagnostics, since X-rays are not a safe method. Its advantages are low prices (in public institutions - free of charge) and great availability, because sinus images are taken even urgently, that is, immediately after injury. This procedure usually takes less than 20 minutes and can only be performed by radiologists. An x-ray of the nose with sinusitis is done necessarily in two projections (the “standing” position and the “lying” position). Both images should be studied by the doctor, based on them, a decision will be made on further treatment.

Let us mention right away that this method does not even require special training, and, as mentioned earlier, it can even be carried out urgently! Sometimes it is necessary to do the x-ray procedure of the sinuses in the presence of sinusitis several times. The fact is that sometimes the treatment is ineffective, as a result of which the symptoms persist, and some complications also arise. In severe cases, everything can even reach inflammation of the membranes of the brain, as well as the eye sockets. Bone changes can be seen if a classic panoramic x-ray is taken.

The doctor may prohibit x-rays if the patient has undergone this procedure many times before.

Indications and contraindications for the procedure

It is important to familiarize yourself with the list of indications and contraindications for this procedure. The fact is that an x-ray can completely harm your health if you ignore the rules regarding admission to the procedure. But first, let's look at the indications for holding, here is a list of them:

• various clinical manifestations resembling sinusitis, for example, severe nasal congestion, facial pain, etc.;
• tumors (both benign and malignant);
• penetration into this area of ​​any foreign bodies;
• the appearance of bleeding;
• trauma;
• pain in the head for unknown reasons;
• cysts;
• the development of caries of the upper teeth, as well as the need for an operation associated with implantation;
• polyposis diseases that affected the nasal concha.

Important! An x-ray of all the maxillary sinuses is able to reveal blackouts characteristic of sinusitis. If you have a bacterial infection, then, most likely, the specialist will see purulent fluid in the pictures. If a total or, for example, subtotal, darkening of all the walls related to the maxillary sinuses is detected, the specialist concludes that you are experiencing proliferative changes caused by hyperplastic sinusitis.

As for the contraindications that limit the possible situations of the procedure, it is forbidden to do an x-ray if you are pregnant. The fact is that scientists have long proved the negative impact of such ionizing X-ray radiation on the fetus. It should be understood that X-rays are prohibited not only in the initial stages, but also later ones. You can not do x-rays in situations where you have already exceeded the allowable number of procedures per year!

It is ineffective to treat sinusitis with medications alone.

Symptoms

Here are the main symptoms of various types of sinusitis, if any, you should immediately contact a specialist who will examine you and write out a referral for x-rays:

• headaches that appear constantly and for no apparent reason;
• pain that occurs in the region of the nose, as well as temples, eyebrows or forehead;
• constant dizziness;
• problems associated with general well-being, decreased performance;
• smell problems;
• labored breathing;
• excessive sweating;
• loss of appetite;
• tearing;
• sleep disorders;
• swelling that appears on the face (most often it is localized in the cheeks or eyelids).

Note! If you notice these symptoms in yourself, contact a qualified doctor immediately. So you can diagnose the disease at an early stage, then the treatment will be as effective and effective as possible. Otherwise, if you start the disease, there will be a risk of developing serious complications!

If there is no pathology in the sinuses, then the bone walls on the x-ray will have clear contours.

Carrying out the procedure

X-ray of the sinuses is an incredibly effective method for diagnosing sinusitis. As mentioned earlier, special preparation for this procedure is not required, but it is important to never forget that there are contraindications, the list of which was presented earlier. We also mention that children are not recommended to do x-rays, or the number of procedures should be reduced to a minimum. The fact is that the children's body is much more susceptible to harmful ionizing radiation, which at an early age can cause serious harm to health. Here are the main steps in this process:

1. First, the radiologist will explain in detail to the patient the essence of the entire diagnostic process, this is necessary in order for everything to happen in accordance with the requirements, then the images will be clear and informative.
2. The person will have to rely on such parts of the face as the nose and chin, in the rack of the apparatus, which will be adjusted in advance to the height of the patient. After that, the doctor will leave the room and begin setting up the equipment.
3. From the next room, a speakerphone specialist will tell you what to do next. Just follow his instructions, then there will be no problems. The essence of such instructions will be to hold your breath when you need to take a picture. The duration of the breath hold will be short, a maximum of 10 seconds. When the picture is taken, it will be fixed and signed, then it will need to dry.
4. It is important to understand that in some situations it is necessary to take pictures in several projections, namely, in two. The fact is that sometimes it is required to control the condition of the sinuses and in the supine position. Thus, it is possible to accurately conclude the presence of sinusitis. The description will be handed over to you, after which you will have to take it to your doctor.

Description of sinusitis in the picture

We will immediately mention that it is impossible to decipher the radiograph on your own in any case! The fact is that only a qualified specialist can do this competently.

In the pictures, soft tissues are almost invisible, they show only bones that have a lighter shade. As for the sinuses, they have a characteristic elongated oval shape, and in the pictures they are expressed in a dark color. The conclusion about the presence of sinusitis and other problems with the sinuses can be drawn on the basis of a simple comparison with the eye sockets. If the color is the same, then everything is normal, that is, there are no pathological processes.

In the presence of light shadows in the pictures, the specialist concludes that there is purulent content, and this phenomenon is called "darkening". X-ray can show the degree of filling of the sinuses with pathological fluid. If there is a large amount of it, the dimming is huge.

It is worth mentioning that the symptoms of sinusitis are often called milk in a glass. The fact is that, as you might guess, according to the information described earlier, the maxillary sinuses have some properties with a vessel, and a liquid with milk. In the absence of sinusitis, the impression of an "empty vessel" is created, as is observed in the eye sockets.

Note! Yes, radiography is an excellent way to detect a disease, but this is where its capabilities end, since the type of disease, as well as its form, cannot be identified. And this is important, because the contents in some cases may include blood, mucus or pus. For this reason, it is often important to use other diagnostic methods, if necessary.

X-ray of the paranasal sinuses- radiographic method of examination of the paranasal sinuses. An x-ray of the sinuses allows you to assess the presence of inflammation, fluid, as well as fractures, displacement of the bones of the nose.

In what cases is required. X-ray of the paranasal sinuses is performed to diagnose the presence of foreign bodies, cysts, tumors, wounded bones, stunted teeth, fractures of the bones of the face, absence and underdevelopment of the sinuses, inflammation of the paranasal sinuses.

Procedure. X-ray of the nose does not require special preparation. Contraindications: pregnancy, lactation, open pneumothorax, pulmonary bleeding. When performing an x-ray, the patient leans on his chin, during the picture it is necessary to keep his mouth open.

Price. The average cost of an x-ray of the paranasal sinuses: 1200 rubles.

Questions and answers:

Where to make an x-ray of the paranasal sinuses in Moscow?

The DocDoc.ru website contains the best clinics in Moscow that perform diagnostic x-rays of the paranasal sinuses. Choose a center for this procedure right on our website according to important criteria for 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 of the diagnostic center. On DocDoc.ru you will find the best centers in Moscow, which you can sort by the cost of the procedure. The questionnaire of each center contains information about its work schedule, as well as a telephone number by which you can immediately sign up for the study.

The sinuses are prescribed by doctors if a patient is suspected of having sinusitis (an inflammatory process in the maxillary sinuses). The examination helps to identify the disease at the initial stage of its development and begin effective treatment that will help stop the development of the lesion and prevent the occurrence of complications. It is important to determine where the x-ray of the sinuses can be taken.

Description of the procedure

The procedure is carried out in several projections:

• chin;
• axial;
• naso-chin.

A picture of healthy sinuses is taken in the naso-chin projection, during the procedure, the patient rests on the stand of the radiographic device with his chin and nose. X-ray helps to accurately determine the condition of the maxillary sinuses and identify all the violations that occur in them.

Main indications

A picture of the sinuses of the nose is an effective diagnostic method with which you can get all the necessary information about the state of the examined organ and circumosseous bones. This procedure is prescribed to patients in the following cases:

• with regular nosebleeds that occur for no clear reason;
• open or closed damage to the bones or cranial facial part;
• at high risk of sinusitis (in this case, the following symptoms are common in a person: severe pain in the head, rhinitis, fever, difficulties with the respiratory system);
• another indication for diagnostics is the suspicion of the presence of polyps, cysts, tumor formations, adenoids and other foreign formations in the nasal cavity;
• to assess the effectiveness of the treatment;
• to prepare for surgery.

Common contraindications for x-rays

Some people cannot take a picture of the paranasal sinuses due to certain contraindications to the procedure. It is forbidden for pregnant women and children under seven years of age. The procedure does not provoke the development of pain syndrome and is characterized by a small dose of radiation entering the human body. Such an examination is contraindicated for pregnant women, since at this time the fetus is highly sensitive to external negative factors. In some cases, radiography during pregnancy causes abnormalities in the structure of the body in the newborn.

In children under the age of seven, x-rays are prescribed in very rare cases, since gamma rays can adversely affect the growth and development of the child's bones. In extreme cases, specialists resort to examining the sinuses of a child using this method (if the examination is more useful than the possible harm received after it).

Sinusitis on x-ray

In the picture of the sinuses with sinusitis, the doctor can detect strongly darkened areas of the upper horizontal level in the lower and middle degrees - this will be a sign of the patient's disease. In the presence of allergic diseases, pillow-shaped protrusions of the mucous membrane can be seen in the picture. They may look like X-ray syndromes (additional formations of medium or increased intensity).

Complete darkening of the maxillary sinuses appears when a large amount of pathological fluid accumulates under the influence of pneumococcus and streptococcus.

An X-ray of the chin projection is carried out as follows: a person stands upright and leans his chin against a special stand. This position helps to clearly visualize the lower maxillary sinuses in the resulting image, and darken the upper ones a little.

Image visualization

The description of the picture of the sinuses is carried out by the attending specialist. Such a projection well visualizes the lattice labyrinths near the nose, which become contaminated during the inflammatory process in the water or maxillary sinuses:

• pyramids of the temporal bones;
• maxillary sinuses over the entire surface.

Compared to the nasochin view, the chin fold view provides a clear view of the lower half of the two sinuses, which are overlapped by the temporal bone pyramids.

The most difficult to visualize is the lattice maze. An anterior X-ray is taken to examine such a pathology.

What can be seen in the resulting image?

With sinusitis, it helps to consider the following structures:

• nasal cavity;
• gaps in the air cavities;
• ocular orbit;
• blackout area;
• frontal bone;
• lattice labyrinth.

A CT scan of the sinuses helps to accurately identify any abnormalities in the nasal cavities. The accumulation of a large amount of fluid can be clearly seen on the radiograph. When considering the structure, special attention should be paid not so much to the severity of the lesion, but to the clarity of the contours of each cell.

In an adult, the cells of the ethmoid labyrinth differ in the following features:

• small size;
• pronounced boundaries;
• average wall thickness;
• violation in the structure of the intercostal septa;
• there is no definite structure of the labyrinth.

An X-ray image helps to clearly visualize all the marked structures. They are described by a radiologist.

Features of the radiography of the nose

During the procedure, the doctor receives an accurate picture of the nasal cavity with blackout areas. Seeing the shadow in the projection of adnexal formations, the specialist concludes that the patient has sinusitis. If there is a cavity with fluid inside, the presence of a maxillary cyst can be assumed.

X-ray examination is prescribed for the diagnosis of swelling and purulent formations in the paranasal sinuses. If, after the procedure, the doctor finds pus in them, he will prescribe a complex treatment with antibacterial drugs. Throughout the course of taking the funds, an additional x-ray is performed, which helps to determine the effect of the therapies.

In the picture during sinusitis, you can see a darkening in the upper horizontal level. At the initial stage of the development of the disease, an accumulation of a small amount of infiltrative fluid can be detected on an x-ray.

Determination of the condition of the maxillary sinuses

To understand whether there is fluid in the maxillary sinuses in a person, one should remember how water behaves in a glass. It always maintains the horizontal level of the liquid inclination even when the object's position changes.

An x-ray of the nose also shows whether a puncture is necessary to eliminate accumulated pus that cannot be removed by simply taking medication.

It is possible to clearly determine the area of ​​​​accumulation of purulent formations from a photograph of the nasal cavity and paranasal formations, carried out in the negative. The x-ray image will help the doctor to make a clear diagnosis and make a more rational treatment for a particular case. In the picture of the sinuses of a healthy person, there are no dark spots and additional formations.

Tumors and x-rays

A snapshot of the paranasal sinuses helps to determine the presence of solid structures in the organ: sarcomas, chondromas or osteomas. Such neoplasms are most often detected by chance when examining the image. When analyzing the resulting image, the specialist pays special attention not only to the location of the eclipse and its size, but also to the "plus-shadows".

In the classic picture, you can see a clear level of accumulated fluid, which helps to make an accurate diagnosis of the disease. In some cases, clear shadows are visible, which are located mainly at the edges.

If there are pronounced thickenings in the nasal mucosa, then this may indicate the presence of the following diseases in humans:

• catarrhal inflammatory process;
• allergy;
• chronic diseases;
• swelling after sinusitis.

X-ray of the accessory cavities of the nose does not have a strong radiation load on the human body. It is considered the only correct way of early diagnosis of inflammatory processes in the paranasal sinuses.

Frequency of the procedure

Many patients wonder how often x-rays of the paranasal sinuses are allowed. After any study in which gamma rays are used, information about the date of the radiation procedure is entered into the patient's outpatient card.

If the doctor reveals that such studies are carried out too often, then he will forbid a second procedure. There is one distinguishing feature: X-rays of the nose will differ in a very small dosage of radiation, so such an event can be carried out as many times as necessary to make an accurate diagnosis.

Interpretation of survey results

In the images obtained after the diagnosis, the specialist can identify inflammatory processes, tumor formations, foreign bodies, cysts, curvature of the nasal septum, and disturbances in the anatomy of the location of the facial bones. Also, this procedure is often used by doctors to determine the patient's sinusitis - an inflammatory process that extends to the membrane of the paranasal sinuses.

After determining the formation in the upper jaw, the specialist diagnoses the patient with sinusitis, in some cases - ethmoiditis, frontal sinusitis or sphenoiditis. If a specialist can diagnose the disease in time, then there is a high chance of a favorable outcome and preventing the development of complications (for example, inflammation of the lining of the brain). All formations of a pathological nature, which are indicated in the picture, are added by specialists to a special medical report, with which after the patient is sent to an appointment with the appropriate doctor.

Digital X-ray is considered more informative and progressive. The picture of the sinuses is projected onto a computer, which helps to conduct a more detailed diagnosis of the organ. In addition, with this procedure, the specialist will be able to save the results in digital format and transfer them, if necessary, via the Internet.

The main disadvantage of this type of examination is the high cost. There is no need to be afraid of radiation therapy and try to avoid x-ray examination. The picture will help the doctor choose an effective treatment for the identified disease.

Where is the procedure performed

Where to take a picture of the sinuses? Examination of the nose and its individual parts can be carried out in a public or private paid medical center in Moscow, St. Petersburg and other cities of the country. Also, a certain price is set for such a procedure, which will depend on a specific clinic:

• X-ray of the paranasal sinuses (in one projection_ - about 1300 rubles;
• A picture of the sinuses (in several projections) - from 1700 rubles.

X-rays of the sinuses are important in the following cases: to determine foreign formations, tumors, cysts, bone damage, problems with tooth growth, deformities of the facial bones, in the absence of sinuses or their underdevelopment, as well as during the inflammatory process in the paranasal sinuses.

Where to take a picture of the sinuses? There are the following Moscow clinics where you can undergo such a diagnostic examination:

• Medical and dental clinic "SHIFA";
• Medical Center "Orange Clinic";
• "Miracle Doctor" on Shkolnaya 49;
• Medical center "Doctor nearby" in Strogino;
• Clinic No. 1 in Lublin.

Carrying out in childhood

X-rays of the sinuses in children under 7 years of age are performed only if there are special indications, since in some cases this procedure leads to slow bone growth and problems with osteogenesis.

Only a doctor can prescribe such a procedure. It should be noted that the suspicion of adenoiditis or sinusitis is not included in the list of indications for such a procedure at a younger age.

For children over the age of 7 years, the procedure is carried out without much concern. But if it is possible to replace it with ultrasound diagnostics or magnetic resonance imaging, then the last two procedures are chosen.

If, due to his age or due to the presence of any diseases, the child cannot fix his head in one position on his own, then the parent, who is previously given a special apron with lead inserts, helps him.