The Diagnostic Value of Sinus Radiography in the Evaluation of Sinusitis

評估鼻竇X光攝影在鼻竇炎的診斷價值

邱碧雲(Pi-Yun Chiu) ； 陳振德(Jen-Dar Chen) ； 張建法(Chien-Fa Chang) ； 魏聰文(Jsong-Wen Wei) ； 張政彥(Cheng-Yen Chang)

《中華放射線醫學雜誌》 35卷3期 (2010/09) Pp. 143-148

摘要

急慢性的鼻竇炎在成人或小孩身上是很常見的疾病，鼻竇X光攝影通常是耳鼻喉科臨床醫師診斷有無鼻竇炎之最主要的影像學檢查方式之一。在本研究中，我們收集了從2008年1月至2009年7月間不含外傷及腫瘤病史的42個病例；其中男性26例、女性16例，年齡在5歲至83歲之間，平均年齡為52.3歲。這些病患是經由耳鼻喉科醫師評估懷疑有鼻竇炎而申請鼻竇X光攝影檢查並且在兩週內執行鼻竇電腦斷層檢查，我們回溯性檢視這些鼻竇X光影像和電腦斷層影像並將兩者結果加以比較。結果顯示這42位懷疑有鼻竇炎的病例當中，電腦斷層皆證實有液體積聚，其中39例X光影像也證實有液體積聚或混濁情形，鼻竇X光檢查診斷有鼻竇炎的靈敏度為92.9%。鼻竇X光診斷液體積聚或混濁在個別鼻竇包括上頷竇、額竇、篩竇、與蝶竇的靈敏度分別為88.6%、88.9%、57%與28.6%。因此，鼻竇X光攝影在偵測上頷竇與額竇有液體積聚或混濁情形的靈敏度最高。鼻竇X光攝影在評估鼻竇炎方面仍然是一項臨床價值相當高的影像診斷工具。

並列摘要

Acute or chronic sinusitis is a common illness among adults and children. Sinus radiography is the primary imaging study that most otolaryngologists utilize when diagnosing sinusitis. In this study, we recruited 42 patients (26 males and 16 females) with age ranging from 5 to 83 years (average: 52.3 years) without a history of trauma or neoplasm, between January 2008 and July 2009. Upon receiving a diagnosis of sinusitis, the patients received sinus radiography followed by computed tomography (CT) within two weeks. Images of both sinus radiography and CT were reviewed retrospectively and compared with each other. The results showed that CT confirmed sinus fluid accumulation in all 42 patients, 39 of them were identified with sinus fluid accumulation or opacification by sinus radiography alone, the sensitivity of 92.9%. For individual paranasal sinus, the sensitivities of sinus radiography for discerning fluid accumulation or opacification in maxillary, frontal, ethmoid, and sphenoid sinuses were 88.6%, 88.9%, 57%, and 28.6%, respectively. Our study confirmed that sinus radiography had a higher sensitivity in detecting fluid accumulation or opacification in the maxillary and frontal sinuses, sinus radiography remains a useful imaging modality in assessing sinusitis in clinical settings.