Zhang Jun, Yang Anni, Chen Tengyu, Cao Yufeng, Lv Qiliang, Xu Yingxiang, Liao Zhenpeng, Chen Xianzhen, Ye Zhongkang, Lai Renjie, Hong Haiyu
Department of Otolaryngology, Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, People's Republic of China.
Allergy Center, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong Province, People's Republic of China.
Ther Clin Risk Manag. 2025 Jun 13;21:895-904. doi: 10.2147/TCRM.S520879. eCollection 2025.
To investigate the diagnostic potency of the opacification-development ratio (ODR) for pediatric chronic rhinosinusitis based on CT scanning.
Children aged 0-15 years who underwent nasal CT scanning from August 2011 through July 2021 were included in the research. The area under receiver operating characteristic curve (AUC) and predictive value were used to assess the diagnostic accuracy of the ODR and Lund-Mackay score based on CT scanning.
A total of 1820 patients (217 in the positive symptom group and 1603 in the negative symptom group) who underwent CT scanning were included in the study. A significant positive correlation was observed between the ODR and the Lund-Mackay score in all age groups. In children aged 0-15 years, the AUC of the ODR and the Lund-Mackay score were 0.7970 and 0.7719, respectively (p > 0.05). The optimal cut-off value for the ODR was 25.83, with a sensitivity of 57.14% and a specificity of 94.2%. In contrast, the optimal cut-off value for the Lund-Mackay score was 6.5, with a sensitivity of 6.5% and a specificity of 85.84%. Notably, the ODR score demonstrated significantly superior performance compared to the Lund-Mackay score in children aged 0-4 years (p < 0.001).
In diagnosing pediatric chronic rhinosinusitis, the use of CT scans is associated with a higher rate of false positives when compared to clinical symptoms. The ODR score based on CT scanning is a valuable diagnostic tool for chronic rhinosinusitis in children aged 0-11, particularly those aged 0-4.
基于CT扫描研究混浊-发展比率（ODR）对小儿慢性鼻窦炎的诊断效能。
纳入2011年8月至2021年7月期间接受鼻窦CT扫描的0至15岁儿童。采用受试者操作特征曲线下面积（AUC）和预测值，基于CT扫描评估ODR和Lund-Mackay评分的诊断准确性。
本研究共纳入1820例接受CT扫描的患者（阳性症状组217例，阴性症状组1603例）。在所有年龄组中，ODR与Lund-Mackay评分之间均观察到显著正相关。在0至15岁儿童中，ODR和Lund-Mackay评分的AUC分别为0.7970和0.7719（p>0.05）。ODR的最佳截断值为25.83，敏感性为57.14%，特异性为94.2%。相比之下，Lund-Mackay评分的最佳截断值为6.5，敏感性为6.5%，特异性为85.84%。值得注意的是，在0至4岁儿童中，ODR评分的表现明显优于Lund-Mackay评分（p<0.001）。
在诊断小儿慢性鼻窦炎时，与临床症状相比，CT扫描的假阳性率更高。基于CT扫描的ODR评分是诊断0至11岁儿童慢性鼻窦炎的有价值工具，尤其是0至4岁儿童。
