NEW !

Apuntes de Fisiologa, Anatoma-radiolgicaclnica

Seminarios Taller Presencial junio ..2009 Clnica de Asma y Alergia III.Parte

CT, MRI , Ultrasonido, Imagenologa Sinusitis Crnica otras patologas

Lean las
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notas al pie de las diapositivas

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Anatoma radiologica CT Scan Cortes axiales, Sagitales y Reconstruccin coronal.. New ! Update d Dr. JuanRevisin Salazar Herrera
Clnica de Asma y Alergia
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Dr. Juan Herrera Salazar

Foro Mdico Nicaragense Portales Mdicos Medbook Mi blog de Asma y Alergia

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Bibliografa
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, and
Author: Belachew Tessema, MD; Chief Editor: Arlen D Meyers, MD, MBA. Updated: Mar Seminarios Anatoma Clnico Radiolgica 29, 2011 13/04/2012
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Anomalies on CT Scan

Bibliografa Emedecine
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...
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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 the sinuses 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 as disease lasting less than 1 month. Subacute disease lasts 1-3 months, and chronic sinusitis lasts longer than 3 months and is generally related to suboptimally treated acute or subacute disease. Acute and subacute sinusitis are treated medically, whereas chronic sinusitis may Seminarios Anatoma Clnico Radiolgica Tel. 13/04/2012 22781169,22703359,surgical intervention. require 88825513,89465022

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Radiografa de los Senos Nasales

Waters

(occipitomental) Caldwell (occipitofrontal)

Vista Lateral Vista basilar (

submento-vrtice) Polypoid mucosal thickening in the right maxillary sinus with a mucous retention cyst in the left on a Waters view.
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CT Scan Metodo Preferido

Computed tomography (CT) scanning is the examination of choice in sinusitis, particularly in cases of chronic sinus disease, providing excellent detail of sinus anatomy. However, CT is usually not useful in acute sinusitis, as diagnosis in acute cases is primarily based on clinical findings. Good anatomic definition is desirable before surgical intervention.

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Coronal CT imaging is the preferred initial procedure. Bone-window views provide excellent resolution and good definition of the complete ostiomeatal complex and other anatomic details that play a role in sinusitis. In addition, the coronal view is best correlated with findings Seminarios Anatoma Clnico Radiolgica Tel. from sinus surgery, with anatomy 22781169,22703359, 88825513,89465022 and pathology visualized in a plane

CT provides an excellent anatomic display of soft-tissue attenuation. This depiction includes fluid levels and polypoid masses within the normally air-filled cavities of the sinuses, nasal cavity, and postnasal space. Most important, disease extending beyond the bony perimeters of the sinuses into the adjacent soft tissue of the orbit,[7] brain, and infratemporal fossa can be imaged. In general, nonenhanced CT scans suffice in cases of uncomplicated sinusitis. Multisection CT seems to have the potential to replace primary coronal CT of the paranasal sinuses without any loss of image quality, and it may even improve the overall 13/04/2012 diagnostic value. However, the

Tomografa Axial Computadorizada (TC) de los senos paranasales

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Si desean ms resolucin hagn clik inforadiologie.ch

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Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513,89465022

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CT Scan Anatomia y Fisiologa

CT scan, nasal cavity.
Normal anterior

ostiomeatal complex anatomy. The anatomy of the ethmoid infundibulum and the uncinate process is demonstrated here.
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CT Scan Anatoma The uncinate process (UP) and lateral wall of y Fisiologa the nasal cavity form
the ethmoid infundibulum (EI). The above sinuses drain into the EI via various ostia. The maxillary sinus ostia and the frontal sinus recess or duct drain into the anteriormost portion of the OMC and are consistently identifiable on CT scan. Normal frontal recess/duct. Frontal sinus empties into the middle meatus just lateral to the more anterior portion of the 13/04/2012 middle turbinate. The

COM Complejo Osteo Meatal

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CT Scan Anatoma y Fisiologa

Stammberger and

Messerklinger Drainage
Normal posterior

Complejo Osteo Meatal Posterior Normal

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ostiomeatal complex. The vomer separates the two ostia into the sphenoid sinus. These ostia are located in the sphenoethmoid recess. The vomer is 13/04/2012 normally

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CT Scan Anatoma y Fisiologa

A normal sagittal

reconstruction of the OMC, showing the curved edge of the semilunar hiatus with the inferior mucosal edge covering the UP, can be seen in the image below. The frontal recess is also shown.

Complejo Osteo Meatal Posterior Normal

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Anomalas de la Cavidad Nasal

Fusion (apparent) of

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uncinate process to the ethmoid floor. Note the normal uncinate process on the other side. Airway flow is compromised from the sinuses to the middle meatus because of the functionally occluded semilunar hiatus. Because the maxillary sinus is patent and aerated, this is not13/04/2012 a

Anomalas de la Cavidad Nasal

Congenital or true

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fusion of the uncinate process to the orbit floor. The maxillary sinus is hypoplastic and not aerated. The ethmoid infundibulum does not exist or ends blindly as the recessus terminalis. The UP tip can also fuse directly to the lateral wall or lamina papyracea of the orbit. This anomaly produces the same imaging findings as inferomedial 13/04/2012 fusion.

Anomalas de la Cavidad Nasal

Bilateral pneumatization of the uncinate tips. Expansion of the tips can compromise the ethmoid infundibulum, the semilunar hiatus, or the middle meatus.
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Anomalas de la cavidad nasal

Concha bullosa of the

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left middle turbinate with expansion and narrowing of the ethmoid infundibulum and the middle meatus. Note absence of the right uncinate process, another anatomic variant.
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Anomalas de la cavidad nasal

Large Haller air cell clearly narrowing the ethmoid infundibulum.

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Anomalas de la cavidad nasal

Overexpansion of the

ethmoid sinus floors

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Patrones radilogicos al CT Scan

Bilateral ethmoid sinusitis on an MRI.

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Complejo Osteomeatal
Mucosal thickening in the left anterior ethmoid and maxillary sinuses and in the region of the infundibulum. This indicates an ostiomeatal pattern of sinusitis
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Conca Bulosa

Concha bullosa of the right middle turbinate.

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Celdas de Haller
Paradoxical curves of

both middle turbinates cause narrowing of the ostiomeatal units.

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Para los especialistas

Magnetic Resonance

Imaging
Ultrasonography

Sinusitis Imaging

Nuclear Imaging
Angiography

Author: Rochita V Ramanan, MBBS, MD, DNB, DMRD; Chief Editor: L Gill Naul, MD

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 CT scan

Spiral CT scan

1mm cuts Magnetic Resonance Imaging

The exclusive use of coronal CT scans for sinus imaging could result in the failure to diagnose nasal cavity neoplasms. In the absence of bone destruction, an esthesioneuroblastoma or other neoplasm may be mistaken for a nasal polyp on a CT scan, whereas on MRI, the nature of this tumor is quite apparent. Beyond anatomic variants, any suspicious findings should be imaged by

Despite advances in MRI technology, insufficient tissue, plus the problems of susceptibility due to the air-containing passages, make MRI a less effective study for nasal cavity sinusitis problems, unless of course the sinusitis turns out to be related to squamous cell carcinoma (SCCa). To date, no new MRI contrast agents that have an affiliation for SCCa have been released

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means of MRI Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513,89465022

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Gracias !

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Seminarios Anatoma Clnico Radiolgica Tel. 22781169,22703359, 88825513,89465022

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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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