McAlister W H, Lusk R, Muntz H R
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.
AJR Am J Roentgenol. 1989 Dec;153(6):1259-64. doi: 10.2214/ajr.153.6.1259.
We performed a prospective study of 70 infants and children with recurrent sinusitis. We compared plain radiographs with coronal CT scans of the sinuses to determine if plain radiographs can be used to accurately diagnose and localize residual sinus disease amenable to endoscopic surgery. This residual disease is thought to be important in the pathogenesis of recurrences of sinusitis. The patients were taking antibiotics and were clinically well at the time of the two examinations (performed on the same day). Findings on slightly over 80% of the CT scans were abnormal. In about 75% of the patients, the findings on plain radiographs did not correlate with those on CT scans. About 45% of the patients had normal findings on plain radiographs of at least one sinus with an abnormality of that sinus shown on CT scans. Almost 35% of the patients had what was interpreted as an abnormality of at least one sinus on plain radiographs, but that sinus was normal on CT scans. Sinusitis in infants and children is often underdiagnosed or overdiagnosed on the basis of findings on plain radiographs of the sinuses. Plain radiographs cannot be used to determine the need for, or to guide, endoscopic surgery on the sinuses.
我们对70例复发性鼻窦炎的婴幼儿及儿童进行了一项前瞻性研究。我们将鼻窦的平片与冠状位CT扫描进行比较，以确定平片是否可用于准确诊断和定位适合内镜手术的残留鼻窦疾病。这种残留疾病被认为在鼻窦炎复发的发病机制中很重要。患者在两次检查（同一天进行）时正在服用抗生素且临床状况良好。略超过80%的CT扫描结果异常。约75%的患者平片结果与CT扫描结果不相关。约45%的患者至少一个鼻窦的平片结果正常，但CT扫描显示该鼻窦有异常。近35%的患者平片显示至少一个鼻窦有异常表现，但CT扫描该鼻窦正常。基于鼻窦平片结果，婴幼儿及儿童鼻窦炎常被漏诊或误诊。平片不能用于确定鼻窦内镜手术的必要性或指导该手术。
