ÇKBT ile akut rinosinüzitin kronik rinosinüzitten ayırt edilmesi.
Öz
Amaç: Akut
rinosinüziti kronik rinosinüzitten klinik olarak ayırt etmek zordur ve bugüne
kadar her iki durumda da benzer görünen hava-sıvı seviyesi veya opaklaşma ile
radyolojik olarak değerlendirilebilirler. Amacımız, klasik radyolojik yaklaşımlarla
birlikte hava dansitesinin analizinin, akut ve kronik rinosinüzit arasında
ayrım yapmak için yeni bir araç olarak kullanılıp kullanılamayacağını
incelemekti.
Yöntem: Bu retrospektif
çalışma paranazal sinüs çok kesitli bilgisayarlı tomografi (ÇKBT) yapılan 550
hastada toplam 2419 sinüs içermekteydi. Hastalar sinüs durumlarının klinik
tanısına göre üç gruba ayrıldı: grup 1 (n = 176) akut enfeksiyonlu, grup 2 (s =
191) kronik rinosinüzitli hastaların oluşturduğu ve grup 3 (s = 181) sağlıklı
sinüslerin oluşturduğu gruptur. Herbir gruptaki paranazal sinüsler içerisindeki
ortalama hava yoğunluğu ve standart sapma, hava ile dolu sinüsün merkezindeki
0.5 cm2 lik ilgili alan (ROI) sinüs duvarı hariç olmak üzere hesaplandı ve
ölçüm takip eden 4-6 BT kesitinde tekrarlandı.
Bulgular: Ortalama hava
dansitesi grup 1'de grup 2 ve 3 ile karşılaştırıldığında anlamlı olarak
yüksekti (sırasıyla - 810 HU, -973 HU ve -1010 HU; p <0.05) ve SD (89.3 HU,
21.1 HU ve 20.9 HU sırasıyla; p <0.05).
Sonuç: Paranazal
sinüslerde artmış hava yoğunluğu akut rinosinüzitin kronik rinosinüzitten
ayrılmasında yardımcı olabilir.
Anahtar Kelimeler
çok kesitli bilgisayarlı tomografi rinosinüzit hava yoğunluğu
Kaynakça
- Referans 1- Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisenberg S, Ganiats TG et all. Otolaryngol Head Neck Surg. 2007 Sep;137(3 Suppl):S1-31. Clinical practice guideline: adult sinusitis.
- Referans 2- Riechelmann H, Giotakis A, Kral F Laryngorhinootologie. Acute Rhinosinusitis in Adults - EPOS 2012 Part II. 2013 Nov;92(11):763-76.
- Referans 3- Quadri N, Lloyd A, Keating KN, Nafees B, Piccirillo J, Wild D. Psychometric evaluation of the Sinonasal Outcome Test-16 and activity impairment assessment in acute bacterial sinusitis.Otolaryngol Head Neck Surg. 2013 Jul;149(1):161-7
- Referans 4- Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F et all. European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012 Mar;50(1):1-12.
- Referans 5- Meltzer EO, Hamilos DL, Hadley JA, et al. Rhinosinusitis:establishing definitions for clinical research and patient care. Otolaryngol Head Neck Surg 2004; 131(6 suppl):S1–S62.
- Referans 6-Hirshoren N, Turner YN, Sosna J, Hirschenbein A. Maxillary air density measurements for differentiating between acute and chronic rhinosinusitis. AJR Am J Roentgenol. 2013 Dec;201(6):1331-4.
- Referans 7- Williams JW Jr, Simel DL, Roberts L, Samsa GP. Clinical evaluation for sinusitis. Making the diagnosis by history and physical examination American Academy of Pediatrics. Subcommittee on Management of Sinusitis and Committee on Quality Improvement. Clinical practice guideline: management of sinusitis Pediatrics. 2001;108:798-808.) (. Ann Intern Med. 1992;117:705-710.)
- Referans 8- Diament, Michael J.; Senac, Melvin O. Jr.; Gilsanz, Vicente; Baker, Sherryl; Gillespie, Terri; Larsson, Sven. Prevalence of Incidental Paranasal Sinuses Opacification in Pediatric Patients: A CT Study. Journal of Computer Assisted Tomography: May/June 1987;11:426-431.
- Referans 9- Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases.Mandell GL, Bennett JE, Dolin R.7th edition.2010. volume 1.p844. ISBN:90078-0-4430-6839-3.
- Referans 10- Aust R, Falck B, Svanholm H. Studies of the gas exchange and pressure in the maxillary sinuses in normal and infected humans. Rhinology. 1979 ;17:245-251.).
- Referans 11- Aust R, Stierna P, Drettner B. Basic experimental studies of ostial patency and local metabolic environment of the maxillary sinus. Acta Otolaryngol Suppl. 1994;515:7-10.
Differentiation of acute rhinosinusitis from chronic rhinosinusitis using MDCT
Öz
It is
difficult to differentiate acute from chronic rhinosinusitis clinically, and to
date they are assessed radiologically via air-fluid level or opacification,
which can appear similar in both cases. Our purpose was to examine whether air
density analysis combined with classical radiological approaches can be used as
a new tool to differentiate between acute and chronic sinusitis.
This
retrospective study included a total of 2419 sinuses in 550 patients who
underwent paranasal sinus multidetector computed tomography (MDCT). Patients were divided into three groups
according to clinical diagnosis of sinus status: acutely inflamed as group 1
(n=176), the chronic sinusitis as group 2 (n=191) and healthy sinuses (n=183)
as group 3, the control group. The mean air density and standard deviations
(SD) within the paranasal sinuses in each group were calculated by the
measurements of air density with a region of interest (ROI) of 0.5 cm2,
located in the center of the air-filled sinus avoiding the sinus wall, and
repeated the measurement in 4-6 consequent CT slices, where available.
The mean
air density was significantly higher in group 1 compared with group 2 and 3 (-
810 HU,-973 HU and -1010 HU respectively; p < 0.05), as well as SD (89.3 HU,
21.1 HU and 20.9 HU respectively; p < 0.05).
In
conclusion; increased air density in paranasal sinuses may aid in
distinguishing acute from chronic rhinosinusitis.
Anahtar Kelimeler
multidetector computed tomography rhinosinusitis air density
Kaynakça
- Referans 1- Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisenberg S, Ganiats TG et all. Otolaryngol Head Neck Surg. 2007 Sep;137(3 Suppl):S1-31. Clinical practice guideline: adult sinusitis.
- Referans 2- Riechelmann H, Giotakis A, Kral F Laryngorhinootologie. Acute Rhinosinusitis in Adults - EPOS 2012 Part II. 2013 Nov;92(11):763-76.
- Referans 3- Quadri N, Lloyd A, Keating KN, Nafees B, Piccirillo J, Wild D. Psychometric evaluation of the Sinonasal Outcome Test-16 and activity impairment assessment in acute bacterial sinusitis.Otolaryngol Head Neck Surg. 2013 Jul;149(1):161-7
- Referans 4- Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F et all. European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012 Mar;50(1):1-12.
- Referans 5- Meltzer EO, Hamilos DL, Hadley JA, et al. Rhinosinusitis:establishing definitions for clinical research and patient care. Otolaryngol Head Neck Surg 2004; 131(6 suppl):S1–S62.
- Referans 6-Hirshoren N, Turner YN, Sosna J, Hirschenbein A. Maxillary air density measurements for differentiating between acute and chronic rhinosinusitis. AJR Am J Roentgenol. 2013 Dec;201(6):1331-4.
- Referans 7- Williams JW Jr, Simel DL, Roberts L, Samsa GP. Clinical evaluation for sinusitis. Making the diagnosis by history and physical examination American Academy of Pediatrics. Subcommittee on Management of Sinusitis and Committee on Quality Improvement. Clinical practice guideline: management of sinusitis Pediatrics. 2001;108:798-808.) (. Ann Intern Med. 1992;117:705-710.)
- Referans 8- Diament, Michael J.; Senac, Melvin O. Jr.; Gilsanz, Vicente; Baker, Sherryl; Gillespie, Terri; Larsson, Sven. Prevalence of Incidental Paranasal Sinuses Opacification in Pediatric Patients: A CT Study. Journal of Computer Assisted Tomography: May/June 1987;11:426-431.
- Referans 9- Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases.Mandell GL, Bennett JE, Dolin R.7th edition.2010. volume 1.p844. ISBN:90078-0-4430-6839-3.
- Referans 10- Aust R, Falck B, Svanholm H. Studies of the gas exchange and pressure in the maxillary sinuses in normal and infected humans. Rhinology. 1979 ;17:245-251.).
- Referans 11- Aust R, Stierna P, Drettner B. Basic experimental studies of ostial patency and local metabolic environment of the maxillary sinus. Acta Otolaryngol Suppl. 1994;515:7-10.