鼻竇電腦斷層之不同視窗造成Lund-Mackay計分的影響

The Difference of Lund-Mackay Scoring Effected by Different Windows of Sinonasal Computed Tomography

張馨丰(Hsin-Feng Chang) ； 陳建志(Jiann-Jy Chen) ； 陳登郎(Dem-Lion Chen) ； 沈里國(Li-Kuo Shen)

《南臺灣醫學雜誌》 10卷1期 (2014/06) Pp. 44-49

https://doi.org/10.6726/MJST.201406_10(1).0005

摘要

目的：在以電腦斷層研究慢性鼻及鼻竇炎時，Lund-Mackay計分是相當簡便且客觀的評估方法，但在不同的視窗條件下或許會對計分造成影響。方法：2011年5月1日至2012年1月19日間，共有187名患者（男107、女80），年齡48.5 ± 15.7歲（平均值士標準差），因慢性鼻及鼻竇炎接受鼻竇電腦斷層檢查，游離輻射劑量長度乘積773.6 ± 78.3 mGy-cm。回溯其影像，分別在軟組織視窗（中心值45HU。窗幅值350HU）、骨視窗（中心值350HU，窗幅值2,000HU）及脂肪視窗（中心值-150HU，窗幅值1,500HU）下進行Lund-Mackay計分。統計分析採用配對t檢定，α值為.05。結果：兩側Lund-Mackay計分總分在脂肪視窗（9.15 ± 5.94）與骨視窗（9.04 ± 5.43）間不具差異（p = .589），但在軟組織視窗（8.28 ± 5.45）與脂肪視窗間，或者軟組織視窗與骨視窗間具有差異（p ＜ .0001）。結論：不同視窗條件可能會對Lund-Mackay計分造成明顯的差異。在進行有關Lund-Mackay計分之研究時，不僅應當闡明所採用的視窗條件，在同一研究中，亦應前後採用一致的視窗條件，這樣結果的判定才會客觀與公平。由於骨視窗或脂肪視窗可以較軟組織視窗呈現較多的軟組織與骨質，運用於Lund-Mackay計分會較為恰當。

關鍵字

鼻竇電腦斷層 ； 慢性鼻及鼻竇炎 ； Lund-Mackay計分 ； 視窗中心值 ； 視窗窗幅值

並列摘要

Objective: Lung-Mackay scoring system (LMS) of computed tomography has been an easy and objective assessment to study chronic rhinosinusitis. We are interested in the LMS difference at different conditions of window center (WC) and window width (WW). Methods: Between May 1st 2011 and January 19th 2012, IS7 sufferers (107 men and 80 women) of chronic rhinosinusitis, aged 48.5 ± 15.7 (average ± SD), were enrolled because they have received sinonasal computed tomography with radiation dose length product of 773.6 ± 78.3 mGy-cm. Their sinonasal images were reviewed. We tried to score the LMS under soft tissue window (WC 45, WW 350), bone window (WC 350, WW 2,000) and adipose window (WC -150, WW 1,500). The data were statistically analyzed with a paired t-test (α = .05). Results: The bilaterally total LMS differs between adipose window (9.15 ± 5.94) and bone window (9.04 ± 5.43), but is different between soft tissue window (8.28 ± 5.45) and adipose window (p ＜ .0001), and is also between soft tissue window and bone window (p ＜ .0001). Conclusions: We performed a preliminary study to confirm the LMS would significantly differ at a different window condition. We need to elucidate the window condition and use the same WC and WW around the study when performing a LMS study and this will help to ensure that the result is more objective and equitable. Because bone window or adipose window, demonstrating more information of soft tissue and bone than soft tissue window, is recommended for LMS.

並列關鍵字

sinonasal computed tomography ； chronic rhinosinusitis ； Lund-Mackay scoring ； window center ； window width