Poor Reproducibility in the Evaluation of Paranasal Sinus X-Rays in Chronic Rhinosinusitis

• 作者: A. Luukkainen A. Markkola E. Terna H. Huhtala J. Jarnstedt J. Numminen K. Blomgren M. Karjalainen M. Rautiainen P. Dastidar P. Kauppi S. Toppila-Salmi
• 来源期刊: 放射学期刊(英文)
• 学科: 医学
• 关键词: SINUSITIS PARANASAL SINUS Computed Tomography Magnetic Resonance Imaging X-RAY
• 年，卷（期）: 2017,（1）
• 页码范围: 23-34
• 页数: 12页
• 分类号: R73

摘要

Objective: The aim of this study was to evaluate intra- and inter-observer reproducibility of sinus x-rays in comparison to sinus computed tomography (CT) in chronic rhinosinusitis (CRS) patients. Methods: This was a prospective controlled study for which 14 adult CRS patients were recruited. Patients underwent a sinus multi-detector CT scan as well as additional sinus x-rays at the same time. Symptom interview and skin prick tests were performed. Lund-Mackay (LM) scores and 43 other findings in paranasal sinuses were analyzed by three blinded observers from CT-scans and x-rays. We compared agreement between sinus CT and x-rays (intra-observer reproducibility) and between three observers (inter-observer reproducibility) by Cohen’s kappa. Results: In at least 90% of the cases, the status of 47/49 structures was detectable in CT scans, whereas the status of only 8/49 structures was detectable in x-rays. The majority of the 25 visualized structures had poor intra-observer and inter-observer reproducibility. Conclusion: Only a few structures can be visualized in paranasal sinus x-rays and compared to paranasal sinus CT-scans, their reproducibility is poor. Our results strongly support the current consensus of radiation dose reduction by limiting the number of x-rays.