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Poor Reproducibility in the Evaluation of Paranasal Sinus X-Rays in Chronic Rhinosinusitis

Open j.urnal of Radiology 2017年第1期7卷 23-34页

作者： A. Luukkainen E. Terna j. Numminen A. Markkola P. Dastidar j. jarnstedt H. Huhtala M. Karj.lainen K. Blomgren P. Kauppi M. Rautiainen S. Toppila-Salmi Transplantation Laboratory Haartman Institute University of Helsinki Helsinki Finland Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Department of Ear and Oral Diseases Tampere University Hospital Tampere Finland University of Helsinki and HUS Imaging Helsinki Finland Medical Imaging Centre Department of Radiology Tampere University Hospital Tampere Finland School of Health Sciences University of Tampere Tampere Finland Department of Otorhinolaryngology University of Helsinki and Helsinki University Hospital Helsinki Finland Department of Allergy University of Helsinki and Helsinki University Hospital Helsinki Finland Department of Otorhinolaryngology University of Tampere Tampere Finland

Obj.ctive: The aim of this study was to evaluate intra- and inter-observer reproducibility of sinus x-rays in comparison to sinus computed tomography (CT) in chronic rhinosinusitis (CRS) patients. Methods: This was a prospective controlled study for which 14 adult CRS patients were recruited. Patients underwent a sinus multi-detector CT scan as well as additional sinus x-rays at the same time. Symptom interview and skin prick tests were performed. Lund-Mackay (LM) scores and 43 other findings in paranasal sinuses were analyzed by three blinded observers from CT-scans and x-rays. We compared agreement between sinus CT and x-rays (intra-observer reproducibility) and between three observers (inter-observer reproducibility) by Cohen’s kappa. Results: In at least 90% of the cases, the status of 47/49 structures was detectable in CT scans, whereas the status of only 8/49 structures was detectable in x-rays. The maj.rity of the 25 visualized structures had poor intra-observer and inter-observer reproducibility. Conclusion: Only a few structures can be visualized in paranasal sinus x-rays and compared to paranasal sinus CT-scans, their reproducibility is poor. Our results strongly support the current consensus of radiation dose reduction by limiting the number of x-rays.

关键词： Sinusitis Paranasal Sinus Computed Tomography Magnetic Resonance Imaging X-Ray

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