Combining images with text in a cohesive manner requires planning and problem solving and is a necessity in graphic design. Most designers prefer to see an optical alignment between the tops of images and the tops of blocks of text. It gets even sexier when the top of the image is aligned with the x-height of the top line of text in the text block. This gives a better visual and optical alignment.
In the example paragraph below, I’ve merely applied the severely under-used ex unit value to the positioning of the image. The result is the perfect optical alignment with the top of the paragraph it lives in.