Mustafa Fatih ERKOÇ, Bilge ÖZTOPRAK, Mansur DOĞAN, Gürol GÖKSUNGUR

ÇOK KESİTLİ BİLGİSAYARLI TOMOGRAFİ İLE AKUT RİNOSİNÜZİTİN KRONİK RİNOSİNÜZİTTEN AYIRT EDİLMESİ

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

Differentiation of Acute Rhinosinusitis From Chronic Rhinosinusitis Using Multidetector Computed Tomography

It is difficult to differentiate acute from chronic rhinosinusitis clinically, and to date they are assessedradiologically via air-fluid level or opacification, which can appear similar in both cases. Our purpose was toexamine whether air density analysis combined with classical radiological approaches can be used as a newtool to differentiate between acute and chronic sinusitis.This retrospective study included a total of 2419 sinuses in 550 patients who underwent paranasal sinusmultidetector computed tomography (MDCT). Patients were divided into three groups according to clinicaldiagnosis of sinus status: acutely inflamed as group 1 (n=176), the chronic sinusitis as group 2 (n=191) andhealthy 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 regionof interest (ROI) of 0.5 cm2, located in the center of the air-filled sinus avoiding the sinus wall, and repeatedthe 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 HUand -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 chronicrhinosinusitis.

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