MRI 信号强度评估变应性真菌性鼻-鼻窦炎与 CT 亨氏单位的价值：回顾性研究。

Value of MRI signal intensity in evaluation of allergic fungal rhinosinusitis compared with CT Hounsfield units: Retrospective study.

机构信息

Department of Radiology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.

Department of Radiology, King Saud Medical City, Riyadh, Saudi Arabia.

出版信息

Medicine (Baltimore). 2024 Jul 12;103(28):e38951. doi: 10.1097/MD.0000000000038951.

DOI:10.1097/MD.0000000000038951

PMID:38996133

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11245196/

Abstract

"Allergic fungal sinusitis (AFS)" is typically diagnosed using radiologic images like computed tomography (CT) scans and magnetic resonance imaging (MRI), with the "Hounsfield unit (HU)" in CT scans and T2-weighted images (T2WI) in MRI serving as reliable objective parameters. However, diagnosing AFS might be difficult because of possible signal changes and densities caused by variations in the secretion concentration in the sinus. Few studies have compared the diagnostic performance of MRI and CT scans. This study aimed to investigate the value of MRI signal intensity in evaluating AFS compared with CT HUs. This retrospective study included 111 patients with pathologically confirmed AFS who underwent CT imaging followed by MRI evaluation at King Saud Medical City, Riyadh, Saudi Arabia, from January 2012 to December 2022. Radiographic densities of sinus opacities on CT scan, including the mean HU values, and MRI findings, including signal voids on T1-weighted images and T2WI, were gathered and analyzed. To determine the efficacy of these radiographic characteristics in predicting the disease and the best cutoff value, we employed receiver operator characteristic curves. The mean age was 31.9 ± 15.6 years, and most patients were 74 females (66.7%). The main symptom was nasal obstruction in 73 patients (65.8%). In comparison, between HU and signal void on T2WI, there was moderate predictive performance [area under the curve: 0.856, P = .001]. An ideal HU cutoff value of 69.50 HU was obtained with a sensitivity of 100% and a specificity of 44.7%. However, the receiver operator characteristic for T1-weighted images could not be plotted, as no signal was avoided to predict AFS and it was not statistically significant (area under the curve: 0.566; P = .287). The study found a CT HU of 69.5 can predict MRI T2WI signal values with a void signal, aiding in diagnostic workup and evaluation for AFS.

摘要

“变应性真菌性鼻窦炎（AFS）”通常使用计算机断层扫描（CT）和磁共振成像（MRI）等影像学图像进行诊断，CT 扫描中的“亨斯菲尔德单位（HU）”和 MRI 中的 T2 加权图像（T2WI）是可靠的客观参数。然而，由于鼻窦分泌物浓度的变化可能导致信号变化和密度变化，因此诊断 AFS 可能具有挑战性。很少有研究比较过 MRI 和 CT 扫描的诊断性能。本研究旨在探讨 MRI 信号强度在评估 AFS 方面与 CT HU 的价值。这项回顾性研究纳入了 2012 年 1 月至 2022 年 12 月在沙特阿拉伯利雅得沙特国王医疗城接受 CT 成像和 MRI 评估的 111 例经病理证实的 AFS 患者。收集并分析 CT 扫描鼻窦混浊的放射密度，包括平均 HU 值，以及 MRI 结果，包括 T1 加权图像和 T2WI 上的信号缺失。为了确定这些放射学特征在预测疾病和最佳截断值方面的疗效，我们采用了受试者工作特征曲线。平均年龄为 31.9±15.6 岁，大多数患者为 74 名女性（66.7%）。主要症状为 73 例患者的鼻塞（65.8%）。相比之下，HU 和 T2WI 上的信号缺失之间具有中度预测性能[曲线下面积：0.856，P=0.001]。获得了理想的 HU 截断值为 69.50 HU，其灵敏度为 100%，特异性为 44.7%。然而，由于没有避免信号来预测 AFS，因此无法绘制 T1 加权图像的受试者工作特征曲线，且没有统计学意义（曲线下面积：0.566；P=0.287）。研究发现 CT HU 为 69.5 时可以预测 MRI T2WI 信号值出现信号缺失，有助于诊断性检查和 AFS 的评估。