Chen L C, Huang J L, Wang C R, Yeh K W, Lin S J
Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan.
Asian Pac J Allergy Immunol. 1999 Jun;17(2):69-76.
Paranasal sinus disease and bronchial asthma are frequently associated. Computed tomography imaging is currently the most reliable method for confirming the diagnosis of sinusitis. Due to the cost and amount of radiation during computed tomography, our aim was to analyze whether standard radiography, under computed tomography-control, had a reasonable degree of confidence in the diagnosis of sinusitis. Fifty-three asthmatic patients (42 males and 11 females) with a mean age of 9 years (range 4-14) were enrolled. We evaluated the maxillary sinuses, ethmoidal sinuses, frontal sinuses, and sphenoidal sinuses using standard radiography (Waters' view, Caldwell view, and lateral view) and compared with computed tomography (coronal views), the latter served as a standard. Computed tomography (CT) showed paranasal sinusitis in 58% (31/53) of the asthmatic children. Compared with the results of computed tomography, standard radiography revealed a sensitivity of 81.1% and a specificity of 72.7% for maxillary sinusitis. The sensitivity and specificity for ethmoidal, frontal, and sphenoidal sinusitis were 51.8%, 84.8%; 47.3%, 87.2%; and 40.8%, 93.3%, respectively. In 21 (40%) of the 53 patients, discrepancies were seen between the interpretations of standard radiography c and those of CT scans. In patients with maxillary sinusitis, the correlation between standard radiography and CT was good. However, ethmoidal, frontal, and sphenoidal sinusitis were poorly demonstrated using radiography. Standard radiography can be recommended as a screening method for maxillary sinusitis, but it is not recommended for the diagnosis of other paranasal sinusitis.
鼻旁窦疾病与支气管哮喘常相关。计算机断层扫描成像目前是确诊鼻窦炎最可靠的方法。由于计算机断层扫描的成本及辐射量，我们的目的是分析在计算机断层扫描控制下的标准X线摄影对鼻窦炎诊断是否有合理的可信度。纳入了53例哮喘患者（42例男性和11例女性），平均年龄9岁（范围4 - 14岁）。我们使用标准X线摄影（华氏位、柯氏位和侧位）评估上颌窦、筛窦、额窦和蝶窦，并与计算机断层扫描（冠状位）进行比较，后者作为标准。计算机断层扫描（CT）显示58%（31/53）的哮喘儿童有鼻旁窦炎。与计算机断层扫描结果相比，标准X线摄影对上颌窦炎的敏感性为81.1%，特异性为72.7%。筛窦炎、额窦炎和蝶窦炎的敏感性和特异性分别为51.8%、84.8%；47.3%、87.2%；40.8%、93.3%。在53例患者中的21例（40%），标准X线摄影和CT扫描的解读之间存在差异。在上颌窦炎患者中，标准X线摄影与CT之间的相关性良好。然而，筛窦炎、额窦炎和蝶窦炎在X线摄影中显示不佳。标准X线摄影可推荐作为上颌窦炎的筛查方法，但不推荐用于诊断其他鼻旁窦炎。
