History of sinus surgery with concern for CSF leak sphenoid: previous CT showed dehiscence sphenoid roof and floor. There is low T1 and T2 signal material in the right sphenoid sinus with surrounding mild diffuse mucosal enhancement. There are dehiscences of the right sphenoid sinus walls, which are better depicted on the prior CT. However, there is no evidence of intracranial extension of the sinus contents. There is also mild diffuse mucosal thickening in the right maxillary sinus, which contains secretions. There is trace mucosal thickening in the left frontal and bilateral ethmoid sinuses. The orbits and intracranial structures are unremarkable.
The right sphenoid sinus abnormality may represent chronic sinusitis, perhaps with a superimposed chronic allergic fungal component. Dehiscences of the right sphenoid sinus walls are better depicted on the prior CT, but there is no evidence of intracranial extension of the sinus contents. 