Savolainen S, Pietola M, Kiukaanniemi H, Lappalainen E, Salminen M, Mikkonen P
Department of Otolaryngology, Central Military Hospital, Helsinki, Finland.
Acta Otolaryngol Suppl. 1997;529:148-52. doi: 10.3109/00016489709124108.
This multicenter study comprised 161 consecutive and unselected patients with suspected acute maxillary sinusitis (AMS). Altogether 322 maxillary sinuses were examined radiologically and by untrasound device (US). Of these, 234 antra were punctured, aspirated and irrigated. The volume of secretion coming out by irrigation was evaluated. The results of US, x-ray and irrigation were compared. For US, the proportion of correct positive results was 82.7% when the secretion volume was heavy, 78.6% when the secretion volume was moderate and 84.3% when the secretion volume was slight. When US finding was compared with the puncture result, the US gave false positive results in 8% of the cases and false negative results in 18.5% of the cases. Out of 187 positive irrigation findings, radiographs revealed fluid retention in 99 cases (score 3-6) (53%). Similarly, 11 radiographs showed fluid retention in 47 cases of negative irrigation findings (23.4%). Statistical calculation shows that both US and radiology were equally reliable in diagnosing fluid retention and sinusitis, when the results are compared with the findings of the sinus puncture. US and radiology gave false positive findings almost equally (p > 0.05). On the other hand, when the volume of secretion was slight (< 1 ml), US gave a fluid echo finding more often than radiology showed fluid retention.
这项多中心研究纳入了161例连续且未经挑选的疑似急性上颌窦炎(AMS)患者。总共对322个上颌窦进行了放射学检查和超声检查(US)。其中,对234个窦腔进行了穿刺、抽吸和冲洗。评估了冲洗出的分泌物量。比较了超声、X线和冲洗的结果。对于超声检查,当分泌物量较多时,正确阳性结果的比例为82.7%;分泌物量中等时,为78.6%;分泌物量较少时,为84.3%。当将超声检查结果与穿刺结果进行比较时,超声在8%的病例中给出假阳性结果,在18.5%的病例中给出假阴性结果。在187例冲洗结果为阳性的病例中,X线片显示99例存在液体积聚(评分3 - 6)(53%)。同样,在47例冲洗结果为阴性的病例中,11张X线片显示存在液体积聚(23.4%)。统计计算表明,当将结果与窦腔穿刺结果进行比较时,超声和放射学在诊断液体积聚和鼻窦炎方面同样可靠。超声和放射学给出假阳性结果的情况几乎相同(p > 0.05)。另一方面,当分泌物量较少(< 1 ml)时,超声比放射学更常显示液性回声。