RU2331362C1 - Method of ultrasound examination of paranasal sinus diseases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine and is intended for ultrasound examination of maxillary, frontal and ethmoidal sinuses. Two-dimensional ultrasound scanning of pathological nidus with linear transducers with frequency from 8 to 10 MHz from two sides in axial and sagittal projections, electronic processing of video signal are performed and three-dimensional image on monitor is obtained. Placing multi-frequency linear transducers on diseased area in definite way, ultrasound examination of paranasal maxillary, frontal and ethmoidal sinuses is carried out.

EFFECT: improved quality of image at ultrasound examination of paranasal sinuses; possibility to examine ethmoidal sinus.

3 ex, 5 dwg

Description

The invention relates to medicine and is intended for ultrasound examination of the maxillary, frontal and ethmoid sinuses.

In the practice of otorhinolaryngology, the use of ultrasound presents certain difficulties, since the paranasal sinuses are normally airborne. Therefore, a total reflection of the sound beam occurs at the tissue-air interface, but if the sinus is completely or partially filled with a secret, there is a tumor or thickening of the mucous membrane, the appearance of echo signals is inevitable.

A known method for the diagnosis of diseases of the maxillary sinuses (see AS USSR No. 1519653, class A61B 8/00, 1989) by ultrasound through the oral cavity with a special sensor with a frequency of 2, 3 and 4 MHz. The method used one-dimensional sensors in the form of a trihedral prism with a section of 6 × 6 × 6 mm and a length of 12 mm.

The disadvantage of this method is the low information content of the resulting image due to the placement of the sensor in the oral cavity, as well as the one-dimensional sensor and the low frequency of the ultrasonic signal do not allow studies of the frontal and ethmoid sinuses.

The closest technical solution to the claimed is a known method of ultrasound examination of diseases of the paranasal sinuses (see H. Riechelmann, W. Mann "Ultrasonography of Paranasal Sinus Lesions" // Rhinology, 1992. - No. 14. - P.136-140), including two-dimensional scanning of the pathological lesion, electronic processing of the video signal and obtaining a three-dimensional image on the monitor.

The disadvantage of this method is the low quality of the three-dimensional image due to the use of two-dimensional scanning in one axial projection. In the known method, sectoral sensors were used, which in some cases give a distorted image on the monitor. The frequency of known sensors was from 3.5 to 5 MHz, and this did not make it possible to examine the lesion of the ethmoid sinus.

The task of creating a new method of ultrasound examination of diseases of the paranasal sinuses is to improve the image quality of the studied object, the penetration of ultrasound into tissues and the possibility of examining the ethmoid sinus.

The problem in the method of ultrasound examination of diseases of the paranasal sinuses, including two-dimensional scanning of a pathological lesion, electronic processing of a video signal and obtaining a three-dimensional image, is solved by the fact that two-dimensional scanning of the lesion is carried out by multi-frequency, linear sensors with a frequency of 8 to 10 MHz on both sides in axial and sagittal projections. In the proposed method for examining the paranasal maxillary sinus, scanning begins in the sagittal projection, for which the sensor is installed in the projection area of the anterior sinus wall, while the lower wall of the orbit is visualized and the sensor is moved medially, examining the inner wall of the sinus. Then the sensor is moved laterally and examine the side wall of the sinus. Scanning in axial projection examines the bays of the posterior wall of the maxillary sinus, for which the sensor is installed parallel to the lower edge of the orbit and the scanning angle is changed first towards the upper wall of the sinus, then to its lower wall. To scan the paranasal frontal sinus, the sensor is mounted on the nose bridge in axial projection, then in the sagittal projection and rotated at an angle of 45 ° to the vertical axis of the body. To scan the paranasal ethmoid sinus, a sensor is installed on the lateral outer wall of the nose near the inner corner of the eye.

A distinctive feature of the claimed method from the prototype is that two-dimensional scanning of the lesion is carried out on both sides in axial and sagittal projections, using linear multi-frequency sensors with a frequency of 8 to 10 MHz. At the same time, an ultrasound examination of the maxillary, frontal and ethmoid sinuses is carried out in a new, specific way.

Compared with other methods of ultrasound research of diseases known in medicine (see RF patent No.20113133, class A61B 8/00, 1991; RF patent No. 2284754, class A61B 8/00, 2006) the proposed method allows for using linear sensors with a frequency of 8 to 10 MHz and scanning the lesion in two projections to get a better, and therefore more informative image of the object under investigation on the monitor. At the same time, the penetrating ability of ultrasound sensors with a frequency of 10 MHz allows you to identify pathological changes in such deep paranasal sinuses, such as the ethmoid sinus.

The essence of the claimed method is illustrated by drawings, where figure 1 schematically shows the position of the sensor in the study of the paranasal maxillary sinus in a sagittal projection; figure 2 is the same in axial projection; figure 3 shows the position of the sensor in the study of the paranasal frontal sinus in axial projection; figure 4 is the same in sagittal projection; figure 5 shows the position of the sensor in the study of the paranasal ethmoid sinus.

An example of an ultrasound study of diseases of the paranasal maxillary sinuses.

Patient P., 8 years old, complained of difficulty in nasal breathing and purulent discharge from the nose for 2 weeks. On examination, nasal breathing is difficult, in the nasal cavity purulent discharge in large quantities. The paranasal sinuses are painless on palpation. The patient performed a two-dimensional ultrasound scan of the maxillary sinuses with a linear sensor 1 with a frequency of 8 MHz. The sinuses began to scan in the sagittal projection (see figure 1). Sensor 1 was installed in the projection area of the anterior sinus wall on one side, the lower wall of the orbit was visualized, then sensor 1 was moved medially to examine the internal sinus wall, then laterally to examine the sinus lateral wall. In the diagrams, the movement of the sensor 1 is shown by arrows. After this, a scan of the maxillary sinus was carried out in axial projection (see figure 2). To do this, the sensor 1 was installed parallel to the lower edge of the orbit and the scanning angle was changed, first towards the upper wall of the sinus, then to its lower wall. The procedure was repeated from the opposite side. As a result of scanning in the right maxillary sinus, a free secret and hypoechoic oval-shaped structures, polyps, were found. A cyst was found in the left maxillary sinus in the form of a round-shaped hypoechoic structure associated with the mucous membrane of the lower sinus wall.

An example of performing an ultrasound examination of diseases of the paranasal frontal sinuses.

Patient N., 39 years old, complained of periodically occurring headaches in the right frontal region for a long time. On examination, nasal breathing is free, in the nasal cavity there is scanty mucous discharge. The paranasal sinuses are painless on palpation. The patient performed two-dimensional ultrasound scanning of the frontal sinuses with a linear sensor 1 with a frequency of 8 MHz in axial (see figure 3) and sagittal (see figure 4) projections. In an axial projection, sensor 1 was installed horizontally on the bridge of the nose on one of the frontal sinuses, and the posterior wall of the sinus was visualized. Then, the sensor 1 was installed in a sagittal projection and rotated at an angle of 45 ° to the vertical axis of the body until an image of the sinus was obtained on the monitor of the ultrasound apparatus. Moving the sensor 1 medially, examined the inner wall of the sinus, then - laterally, examined the lateral wall of the sinus. The procedure was repeated from the opposite side, scanning the sinus in two projections. As a result of scanning, an osteoma was detected in the right frontal sinus, which was determined as an anechogenic structure of a rounded shape with clear contours emanating from the bone tissue of the upper sinus wall.

An example of performing an ultrasound examination of diseases of the paranasal ethmoid sinuses.

Patient K., 9 years old, complained of prolonged runny nose and difficulty in nasal breathing. Sick for about 3 months. When viewed in the nasal cavity, abundant mucous discharge is noted. The paranasal sinuses are painless on palpation.

The patient performed a two-dimensional ultrasound scan of the paranasal sinuses in axial and sagittal projections with a linear sensor 1 with a frequency of 10 MHz. When scanning the frontal sinuses, no pathology was found. The sinuses are airy, the back wall of the sinuses is not visualized. A scan of the maxillary sinuses revealed significant swelling of the mucous membrane. When scanning the ethmoid sinuses, sensor 1 was installed on the side wall of the outer surface of the nose near the inner corner of the eye (see Fig. 5), first on the right, then on the left. As a result, edema of the mucous membrane in the ethmoid sinuses was found on both sides.

The proposed method for ultrasound examination of diseases of the paranasal sinuses was tested at the Department of ENT diseases of the Yaroslavl Medical Academy, at the Children's Clinical Hospital No. 3 of Yaroslavl and at the Center for Microendoscopic Otorhinolaryngology of the Yaroslavl Regional Clinical Hospital of Yaroslavl.

Claims (1)

A method for ultrasound examination of diseases of the paranasal sinuses, including two-dimensional scanning of a pathological lesion, electronic processing of a video signal and obtaining a three-dimensional image, characterized in that two-dimensional scanning of the lesion is carried out by linear multi-frequency sensors with a frequency of 8 to 10 MHz from two sides in axial and sagittal projections, for studies of the paranasal maxillary sinus scan begin in the sagittal projection, install the sensor in the anterior wall and sinuses, visualize the lower wall of the orbit and move the sensor medially, while examining the inner wall of the sinus, then laterally inspecting the side wall of the sinus, then scanning the sinus in axial projection, for which the sensor is installed parallel to the lower edge of the orbit and change the scan angle first in the direction of the upper the sinus wall, then to its lower wall, and for scanning the paranasal frontal sinus, the sensor is installed in the axial projection on the nose bridge, then in the sagittal projection and rotate it At an angle of 45 ° to the vertical axis of the torso, moreover, for scanning the paranasal ethmoid sinus, a sensor is installed on the lateral outer wall of the nose near the inner corner of the eye.

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