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Pediatric Nasal Cavity and Paranasal Sinuses Atlas

How to Use

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Introduction

Imaging evaluation of the pediatric paranasal sinuses is complicated by complex 3D anatomy and frequent anatomical variations. While hard copy atlases of the paranasal sinuses exist, these often show only a few selected images of relevant anatomical structures. To facilitate understanding of the imaging anatomy of the paranasal sinuses, we constructed an online, large data-set, digital CT atlas which demonstrates the normal appearance of the paranasal sinuses at various ages throughout childhood. We also constructed five atlases (sphenoid, maxillary, ethmoid, frontal and nasal cavity) which demonstrate color shading of the sinuses for the 15 year normal. In addition, we assembled a teaching file of CT and MR cases, comprised of entire imaging exams that show a variety of neoplastic, inflammatory/infectious, congenital, traumatic and iatrogenic pathologies.

To start the program:

You can start the program from the Start menu, in the Programs folder, under ParanasalSinus Atlas. Alternatively, you can run the program by opening the atlas folder and clicking on the file ParanasalSinusAtlas.exe. You can put a shortcut on the desktop for ease of starting the program.

By default, the module opens in Case Mode (Single Patient, Multiple Series) showing a different series of a selected patient (by default, the 1-year-old normal patient) in each viewing window. No comments or shading are present on these default images. Please see additional instructions below to enable these and other helpful features.

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The box below the menubar contains a list of cases/patients in the module. The first five patients listed are normal exams of five patients, ranging in age from 1 to 15 years old. Following this are five normal “atlases” that are based on the 15-year-old normal patient. By default, these open in unlabeled form. The teaching file cases are also listed in the box. The highlighted case/patient is the one currently assigned to the viewing windows. You can click on any case in the list to start with a new case in the viewing windows, or you can click on the forward and reverse arrows in the first viewing window to move through the cases. You can view teaching file cases in known or unknown format by clicking the Options menu and selecting Alternate List Names.

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To scroll forwards or backwards through a series, left-click on a window and hold the left mouse button as you move the mouse up or down. By default, all appropriately linked windows will scroll at the same time as the window you scroll. If you want to unlink or re-link image scrolling, go into the Options menu and uncheck or check the Link Image Sets When Scrolling option.

Menubar Controls

Case list selection:

The default case list is the Standard List, which contains all of the cases. By clicking Standard List on the menubar you can switch to another list format.

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The Expanded List option is not applicable for this particular module.

The Checked Only list adds checkboxes next to the Standard List cases. This allows you to customize exactly which cases are to be viewed. In this mode, only the checked cases will be shown in the viewing windows.

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Mode selection:

The initial display mode is Case Mode. You can change the display mode by clicking Case Mode on the menubar and then selecting one of the three options that appear. This will then change the menu title to the newly selected option.

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Case Mode allows you to compare multiple series of a single patient. Only one patient will be displayed at a time (the default is the patient in the upper left window, the 1-year-old normal patient). You must right-click each viewing window to load different series for the selected patient. Changing the selected patient will change all the viewing windows and load the selected series for the new patient.

Compare Mode allows you to simultaneously compare the same series over multiple different patients. If you right-click a viewing window and select a series, the program will open that series for all of the selected patients. Only one series can be shown at a time in compare mode. To scroll forwards or backwards through a series, left-click a window and hold the left mouse button as you move the mouse up or down.

Sheet Mode allows you to view one series from one patient in detail. It opens the series that currently resides in the first viewing window into an array viewing mode simulating a printed sheet of film.

Comment selection:

The image sets have comments associated with them. Some comments apply to every image for a given case/patient, while other comments are specific for a given series or even a single image. There are four modes for viewing comments, which can be changed from the comments menu.

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No Comments: No comments shown.

Show Single Image Comments: When you move the mouse over an image, any comments associated with the image will pop up and be shown.

Show All Image Comments: A small comment window will pop up at the bottom of every image window and stay visible, showing the comments associated with each window's image.

Show Whole Comments Only: In this mode comments for Hx, Dx and Report will take up the full window.

Options:

Scrolling Through Series: To scroll through a series, left-click and hold on a window as you move the mouse up or down. This will scroll forwards or backwards through the series. If the series are linked, as they are by default, all appropriately linked viewing windows will scroll at the same time as the viewing window you scroll. If you want to unlink or re-link the image scrolling, go into the Options menu and uncheck or check the Link Image Sets When Scrolling option.

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Alternate List Names: Each case has two names so that they may be viewed in known or unknown format. To toggle between the two names, simply click the Options menu and check or uncheck Alternate List Names.

Window selection:

The viewing windows start out as a 3x1 array. To change the layout of the viewing windows, left-click the Window: 3x1 menu option. This will pop up a small window with a 5x5 grid as shown:

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Move the mouse around on the grid to select the new viewing window arrangement layout that you want, and then click it. The viewing windows will rearrange themselves and load the appropriate series automatically.