Hansen Aleksander Grande, Helvik Anne-Sofie, Nordgård Ståle, Bugten Vegard, Stovner Lars Jacob, Håberg Asta K, Gårseth Mari, Eggesbø Heidi Beate
Department of Ear, Nose and Throat, Head and Neck Surgery, St. Olavs Hospital NTNU, Trondheim, Norway ; Department of Neuroscience, St. Olavs hospital NTNU, Trondheim, Norway.
Department of Ear, Nose and Throat, Head and Neck Surgery, St. Olavs Hospital NTNU, Trondheim, Norway ; Department of Public Health and General Practice, NTNU, Trondheim, Norway.
BMC Ear Nose Throat Disord. 2014 Nov 25;14(1):13. doi: 10.1186/1472-6815-14-13. eCollection 2014.
Diagnostic imaging of the head is used with increasing frequency, and often includes the paranasal sinuses, where incidental opacifications are found. To determine the clinical relevance of such findings can be challenging, and for the patient such incidental findings can give rise to concern if they are over-reported. Studies of incidental findings in the paranasal sinuses have been conducted mostly in patients referred for diagnostic imaging, hence the prevalence in the general population is not known. The purpose of this study was to determine the prevalence and size of incidental opacification in the paranasal sinuses in a non-selected adult population using magnetic resonance imaging (MRI) without medical indication, and to relate the results to sex and season.
Randomly and independent of medical history, 982 participants (518 women) with a mean age of 58.5 years (range, 50-66) underwent MRI of the head as part of a large public health survey in Norway. The MRIs included 3D T1 weighted volume data and 2D axial T2 weighted image (WI). Opacifications, indicating mucosal thickenings, polyps, retention cysts, or fluid, were recorded if measuring more than 1 mm.
Opacifications were found in 66% of the participants. Mucosal thickenings were found in 49%, commonly in the maxillary sinuses (29%) where 25% had opacifications that were less than 4 mm in size. Other opacifications occurred in the anterior ethmoid (23%), posterior ethmoid (21%), frontal sinus (9%), and sphenoid (8%). Polyps and retention cysts were also found mainly in the maxillary sinuses in 32%. Fluid was observed in 6% of the MRIs. Mucosal thickening was observed more frequently in men than in women (P <0.05). No seasonal variation was found.
In this large non-selected sample, incidental opacification in the paranasal sinuses was seen in two out of three participants, and mucosal thickening was seen in one out of two. Fluid was rare. Knowledge of incidental opacification is important because it can affect clinical practice.
头部诊断成像的使用频率日益增加，通常包括鼻旁窦，在此处会发现一些偶然出现的窦腔混浊。确定这些发现的临床相关性可能具有挑战性，而且对于患者来说，如果这些偶然发现被过度报告，可能会引起担忧。关于鼻旁窦偶然发现的研究大多是在因诊断成像而转诊的患者中进行的，因此一般人群中的患病率尚不清楚。本研究的目的是使用无医学指征的磁共振成像（MRI）来确定非选择性成年人群中鼻旁窦偶然出现的窦腔混浊的患病率和大小，并将结果与性别和季节相关联。
在挪威一项大型公共卫生调查中，982名参与者（518名女性）随机且与病史无关，平均年龄为58.5岁（范围50 - 66岁），接受了头部MRI检查。MRI包括三维T1加权容积数据和二维轴向T2加权图像（WI）。如果混浊区域测量值超过1毫米，则记录为提示黏膜增厚、息肉、潴留囊肿或积液。
66%的参与者发现有窦腔混浊。49%的人发现有黏膜增厚，常见于上颌窦（29%），其中25%的人窦腔混浊大小小于4毫米。其他窦腔混浊出现在前筛窦（23%）、后筛窦（21%）、额窦（9%）和蝶窦（8%）。息肉和潴留囊肿也主要在32%的上颌窦中发现。6%的MRI检查中观察到积液。男性比女性更频繁地观察到黏膜增厚（P <0.05）。未发现季节性变化。
在这个大型非选择性样本中，三分之二的参与者出现了鼻旁窦偶然的窦腔混浊，二分之一的参与者出现了黏膜增厚。积液很少见。了解偶然出现的窦腔混浊很重要，因为它会影响临床实践。
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