Magnetic resonance imaging of carotid artery abnormalities in patients with sphenoid sinusitis

• Published in: Neuroradiology 2004, Vol.46 (1), p.54-59
• Main Authors: WONG, A. M, BILANIUK, L. T, ZIMMERMAN, R. A, SIMON, E. M, POLLOCK, A. N
• Format: Article
• Language: English
• Subjects: Adolescent; Biological and medical sciences; Blood vessels; Carotid Artery Diseases - pathology; Cerebral Infarction - pathology; Female; Humans; Infant; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Male; Medical sciences; Nervous system; Neurology; NMR; Nuclear magnetic resonance; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiology; Retrospective Studies; Sphenoid Sinusitis - complications; Sphenoid Sinusitis - pathology
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-003-1111-0

Sphenoid sinusitis is unusual in children, but when it occurs, it can lead to serious intracranial complications. We show the value of MRI in demonstrating intracranial abnormalities due to sphenoid sinus infection, particularly those involving the internal carotid arteries and cavernous sinuses. We reviewed our imaging experience of sphenoid sinusitis and found four patients with ICA narrowing who had undergone MR evaluation including conventional and diffusion imaging. MR angiography was also performed in three patients to determine the extent of ICA narrowing. Narrowing of ICA was found in the cavernous segment in all patients and in the supraclinoid segment in three. Cerebral infarction was found in two patients. In one patient the cavernous sinus showed hyperintensity on diffusion-weighted images and hypointensity on apparent diffusion coefficient map, suggesting reduced diffusion. Although infrequent in children, sphenoid sinus infection should be considered as a possible cause of intracranial infection, particularly in teenagers. Early recognition of cavernous sinus involvement and ICA narrowing may lead to prompt treatment and hence a more favorable outcome.