CECT PNS(Axial + Coronal)

Overview

Contrast Enhanced Computed Tomography (CECT) PNS (Axial + Coronal) is a specialized imaging study of the paranasal sinuses (PNS) that provides highly detailed, cross-sectional views in two planes: axial (horizontal) and coronal (vertical). By using intravenous contrast dye, this scan enhances the visualization of soft tissues, blood vessels, and mucosal structures, offering a layered and multidimensional perspective that helps diagnose infections, tumors, inflammatory conditions, and structural anomalies affecting the sinuses and nearby regions. CECT PNS (Axial + Coronal) is especially valuable for ENT specialists and surgeons as it offers a comprehensive view of sinus anatomy, including the relationship of sinuses to adjacent structures like the nasal cavity, orbit, skull base, and cranial fossa. These images are essential for accurate diagnosis, surgical planning, and monitoring of disease progression or treatment response.

Purpose of CECT PNS (Axial + Coronal)

Doctors may recommend CECT PNS (Axial + Coronal) in a variety of clinical scenarios where detailed evaluation of the paranasal sinuses and related regions is needed. Common purposes include:

1. Chronic Sinusitis and Recurrent Infections

• Detects chronic inflammation, mucosal thickening, and sinus blockage.
• Identifies complications like bone erosion, orbital cellulitis, or abscess formation.

2. Evaluation of Nasal Polyps and Benign Lesions

• Shows size, location, and extent of polyps or mucous retention cysts.
• Helps differentiate between inflammatory lesions and other masses.

3. Tumors and Malignant Lesions

• Identifies masses within the nasal cavity or sinuses.
• Defines spread to adjacent bones, orbits, or intracranial structures.

4. Facial and Nasal Trauma

• Detects fractures of the sinus walls, nasal septum, and adjacent bones.
• Assesses displacement or involvement of critical structures like the orbit.

5. Congenital and Developmental Anomalies

• Evaluates anatomical variations, septal deviations, or abnormal sinus development.
• Important for planning sinus or nasal surgery.

6. Pre-Surgical Mapping

• Provides a detailed roadmap for functional endoscopic sinus surgery (FESS) and other procedures.

7. Vascular Abnormalities

• Visualizes vascular malformations, aneurysms, or prominent vessels near sinus cavities.

8. Post-Surgical Follow-up

• Monitors healing after surgery and detects residual disease or complications.

Procedure for CECT PNS (Axial + Coronal)

This test is usually quick and comfortable, typically lasting 15–20 minutes.

Before the Scan

• Fasting for around 4–6 hours may be advised for better tolerance of contrast dye.
• Inform your doctor if you:
  • Have allergies to iodine-based contrast dye.
  • Have kidney disease, thyroid disorders, or diabetes.
  • Are pregnant or breastfeeding.
• Remove metal items near the head, such as earrings, glasses, or hairpins.

During the Scan

• A small intravenous (IV) cannula is placed to inject the contrast dye.
• You might feel a brief warm sensation, metallic taste, or mild flushing as the dye circulates.
• You’ll lie on the CT table; the technologist may ask you to stay still or hold your breath briefly.
• The scanner captures images in both axial (horizontal) and coronal (vertical) planes.

After the Scan

• You can usually return to daily activities right after the scan.
• Drink plenty of fluids to help flush out the contrast dye.
• A radiologist reviews the images, and your doctor generally receives the report within 24–48 hours.

Benefits of CECT PNS (Axial + Coronal)

• Detailed visualization: Enhances both bone and soft tissue detail, crucial for complex sinus anatomy.
• Two-plane imaging: Axial and coronal views together offer a complete picture of sinus disease and adjacent structures.
• Contrast enhancement: Highlights mucosal lesions, vascular structures, and possible tumor spread.
• Quick and precise: Especially valuable for urgent cases or surgical planning.
• Improves diagnosis: Differentiates between infection, inflammation, and neoplastic processes.

Conditions Commonly Diagnosed

• Chronic sinusitis and acute infections.
• Nasal polyps and mucous retention cysts.
• Benign and malignant sinus or nasal tumors.
• Orbital cellulitis and abscesses.
• Trauma-related fractures of the nasal septum and sinus walls.
• Congenital anomalies like septal deviations and hypoplastic sinuses.
• Vascular malformations involving or near the paranasal sinuses.
• Post-surgical follow-up after procedures like FESS.

Risks and Considerations

While CECT PNS (Axial + Coronal) is generally safe, there are a few considerations:

Radiation Exposure

• Involves ionizing radiation, but protocols minimize exposure, especially in sensitive areas like the orbit and brain.

Contrast Dye Effects

• Mild: nausea, warmth, or metallic taste.
• Rare: allergic reactions; emergency care is available if needed.
• Patients with kidney disease may need renal function tests before the scan.

Pregnancy

• Generally avoided unless medically necessary, to limit fetal exposure to radiation.

Movement Sensitivity

• Remaining still during scanning helps prevent blurred images.

When Might Your Doctor Recommend It?

Doctors might suggest CECT PNS (Axial + Coronal) if you:

• Have persistent or recurrent sinus infections unresponsive to treatment.
• Present with facial pain, nasal obstruction, or unexplained swelling.
• Show symptoms suggesting sinus tumors or masses.
• Suffered facial trauma affecting nasal or sinus structures.
• Need detailed pre-operative planning for sinus surgery.
• Have known congenital anomalies requiring evaluation.
• Need post-surgical assessment to check healing or detect complications.

Conclusion

The paranasal sinuses are complex, air-filled spaces closely connected to the nasal cavity, eyes, and brain. Conditions affecting them can range from chronic sinus infections and nasal polyps to tumors or traumatic injuries. Proper diagnosis and treatment rely heavily on precise, multidimensional imaging. CECT PNS (Axial + Coronal) combines contrast enhancement with dual-plane imaging, offering ENT specialists and surgeons a comprehensive, layered view of sinus anatomy and disease. It highlights soft tissues, vascular structures, and bones, providing the clarity needed to plan surgeries, confirm diagnoses, and guide treatment.