Department of Pediatric Otolaryngology, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572, Poznan, Poland.
Department of Pediatric Otolaryngology, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572, Poznan, Poland.
Int J Pediatr Otorhinolaryngol. 2021 Oct;149:110842. doi: 10.1016/j.ijporl.2021.110842. Epub 2021 Jul 17.
The study aimed to present the accuracy of radiological diagnostics in pediatric patients with nasal dermoids and to discuss the potential factors influencing the radiological pitfalls on imaging in these cases.
The patient's cohort included 25 surgically treated pediatric cases with nasal dermoid. The results of preoperative imaging studies were analyzed regarding intraoperative findings. A review of the literature concerning a series of cases with nasal dermoid was performed in order to evaluate the possible radiological pitfalls and the accuracy of radiological imaging. The following statistical parameters for the particular radiological tools was determined: sensitivity, specificity, predictive positive values and predictive negative values.
Total number of 18 CT and 14 MRI were performed. 6 out of 32 radiological examinations occurred to be inconsistent with operative findings. Potential pitfalls were identified and discussed. All the patients with false radiological results were below the age of 5 and 83% were below the age of 3 y.o. The overall sensitivity (S), specificity (SP), predictive positive value (PPV) and predictive negative value (PNV) for CT vs. MRI were 68% vs. 79%, 90% vs. 95%, 65% vs. 86% and 90% vs. 92%, respectively.
MRI technique characterizes with higher predictive values in terms of identifying intracranial extension of nasal dermoid on imaging. Further analysis of radiological methods' accuracy should be conducted based on the detailed data concerning age distribution. The combination of CT and MRI should become a gold standard in diagnostics of nasal dermoids in children under the age of 5.
本研究旨在展示影像学诊断在儿童鼻部皮样囊肿中的准确性，并讨论影响这些病例影像学陷阱的潜在因素。
本研究纳入了 25 例经手术治疗的儿童鼻部皮样囊肿患者。分析了术前影像学研究的结果与术中发现的相关性。为了评估可能存在的影像学陷阱和影像学检查的准确性，我们对一系列鼻部皮样囊肿病例的文献进行了回顾。确定了特定影像学工具的以下统计参数：敏感性、特异性、阳性预测值和阴性预测值。
共进行了 18 例 CT 和 14 例 MRI 检查。32 次影像学检查中有 6 次与手术结果不一致。确定并讨论了潜在的影像学陷阱。所有影像学结果错误的患者年龄均小于 5 岁，83%的患者年龄小于 3 岁。CT 与 MRI 的总体敏感性（S）、特异性（SP）、阳性预测值（PPV）和阴性预测值（PNV）分别为 68%比 79%、90%比 95%、65%比 86%和 90%比 92%。
MRI 技术在识别鼻部皮样囊肿的颅内延伸方面具有更高的预测值。应根据年龄分布的详细数据进一步分析影像学方法的准确性。CT 和 MRI 的联合应用应成为 5 岁以下儿童鼻部皮样囊肿诊断的金标准。
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