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成人囊性纤维化鼻窦疾病的新型计算机断层扫描评分系统

Novel Computed Tomography Scoring System for Sinus Disease in Adults With Cystic Fibrosis.

作者信息

Sheikh Shahid I, Handly Brian, Ryan-Wenger Nancy A, Hayes Don, Kirkby Stephen E, McCoy Karen S, Lind Meredith

机构信息

Departments of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA

Radiology, The Ohio State University College of Medicine, Columbus, Ohio, USA Radiological Institute, Nationwide Children's Hospital, Columbus, Ohio, USA.

出版信息

Ann Otol Rhinol Laryngol. 2016 Oct;125(10):838-43. doi: 10.1177/0003489416656645. Epub 2016 Jun 29.

Abstract

OBJECTIVE

There is no easy to use scoring system for computed tomography (CT) scans of the sinuses that is specific to cystic fibrosis (CF). We propose a simple and easily implemented scoring system to quantify severity of sinus disease in adults with CF.

STUDY DESIGN

Case series with chart review.

SETTING

Academic tertiary-care referral center.

SUBJECTS

Sixty-nine adult patients with CF and 50 age-matched controls.

METHODS

We validated a scoring system for CF sinus disease. The CT scans were interpreted by 3 physicians on 2 separate sittings. Parameters include maxillary opacification, nasal obstruction, lateral nasal wall displacement, uncinate process absence/demineralization, and presence/absence of mucocele.

RESULTS

Patients with CF aged 21 to 30 years (mean = 24.7 ± 2.49). In CF cohort (n = 69), intrarater reliability for the 10 CT categories ranged from .70 to 1.00. Twenty-six (87%) were in the excellent range, and the remaining 4 (13%) were evaluated as good. In the non-CF cohort (n = 50), reliabilities ranged from .44 to 1.00. Twenty-seven (90%) were in the excellent range. For interrater reliability, in the CF cohort, 10 CT categories across the 3 raters ranged from .55 to 1.00. Excellent reliability was achieved in 15 (50%) of the observations. In the non-CF cohort, reliabilities ranged from .44 to 1.00.

CONCLUSION

A novel and easy to use CT scoring system for CF sinus disease in adults was validated with inter- and intrarater reliability. This new CF sinus disease-specific scoring system can be used by clinicians, surgeons, and radiologists.

摘要

目的

目前尚无专门用于囊性纤维化(CF)患者鼻窦计算机断层扫描(CT)的易用评分系统。我们提出一种简单且易于实施的评分系统,以量化成年CF患者鼻窦疾病的严重程度。

研究设计

病例系列研究并进行图表回顾。

研究地点

学术性三级医疗转诊中心。

研究对象

69例成年CF患者和50例年龄匹配的对照者。

方法

我们验证了一种用于CF鼻窦疾病的评分系统。CT扫描由3位医生在2次独立阅片中进行解读。参数包括上颌窦混浊、鼻塞、鼻侧壁移位、钩突缺失/脱矿以及黏液囊肿的有无。

结果

CF患者年龄在21至30岁之间(平均 = 24.7 ± 2.49)。在CF队列(n = 69)中,10个CT类别的评分者内信度范围为0.70至1.00。其中26例(87%)处于优秀范围,其余4例(13%)评估为良好。在非CF队列(n = 50)中,信度范围为0.44至1.00。27例(90%)处于优秀范围。对于评分者间信度,在CF队列中,3位评分者对10个CT类别的信度范围为0.55至1.00。15例(50%)观察结果达到了优秀的信度。在非CF队列中,信度范围为0.44至1.00。

结论

一种用于成年CF患者鼻窦疾病的新型且易用的CT评分系统在评分者内和评分者间信度方面得到了验证。这种新的CF鼻窦疾病特异性评分系统可供临床医生、外科医生和放射科医生使用。

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