鼻窦计算机断层扫描在儿科造血干细胞移植患者中的作用。
The role of screening sinus computed tomography in pediatric hematopoietic stem cell transplant patients.
作者信息
Zamora Carlos A, Oppenheimer Avi G, Dave Hema, Symons Heather, Huisman Thierry A G M, Izbudak Izlem
机构信息
From the *Division of Neuroradiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD; †Division of Blood and Marrow Transplantation, Children's National Medical Center, Washington, DC; and ‡Sidney Kimmel Cancer Center, Department of Pediatrics and Oncology, and §Division of Pediatric Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD.
出版信息
J Comput Assist Tomogr. 2015 Mar-Apr;39(2):228-31. doi: 10.1097/RCT.0000000000000185.
OBJECTIVE
The objective of this study was to evaluate pretransplant sinus computed tomography (CT) as predictor of post-hematopoietic stem cell transplant sinusitis.
METHODS
We evaluated pretransplant and posttransplant CT findings in 100 children using the Lund-Mackay system and "common-practice" radiology reporting and correlated these with the presence of acute sinusitis.
RESULTS
Fourteen percent of patients with normal screening CT developed posttransplant sinusitis, compared with 23% with radiographic abnormalities and 22% with clinical sinusitis alone, not statistically significant. Sensitivity of CT findings for clinical sinusitis ranged between 19% and 56%. Except for mucosal thickening (71% specificity), other findings had high specificity between 92% and 97%, particularly when combined. Lund-Mackay score change of 10 or greater from baseline was associated with a 2.8-fold increased likelihood of having sinusitis (P < 0.001).
CONCLUSIONS
Screening CT can serve as a baseline, with a Lund-Mackay score change of 10 or greater constituting a significant threshold. The strongest correlation with the presence of acute sinusitis was seen with combined CT findings.
目的
本研究的目的是评估造血干细胞移植前鼻窦计算机断层扫描（CT）作为移植后鼻窦炎预测指标的价值。
方法
我们使用Lund-Mackay系统和“常规”放射学报告评估了100名儿童移植前和移植后的CT表现，并将这些表现与急性鼻窦炎的存在情况进行关联。
结果
筛查CT正常的患者中有14%发生了移植后鼻窦炎，相比之下，影像学异常患者为23%，仅临床诊断为鼻窦炎的患者为22%，差异无统计学意义。CT表现对临床鼻窦炎的敏感性在19%至56%之间。除黏膜增厚（特异性为71%）外，其他表现的特异性较高，在92%至97%之间，尤其是联合出现时。Lund-Mackay评分较基线升高10分或更多与患鼻窦炎的可能性增加2.8倍相关（P < 0.001）。
结论
筛查CT可作为基线，Lund-Mackay评分变化10分或更多构成显著阈值。联合CT表现与急性鼻窦炎的存在相关性最强。
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