Evaluation of low-dose versus standard-dose CT examination in surgical high-risk patients with chronic rhinosinusitis(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2017年第11期
- Page:
- 1137-1141
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Evaluation of low-dose versus standard-dose CT examination in surgical high-risk patients with chronic rhinosinusitis
- Author(s):
- GUO Guangwei1; MO Xianhai1; CHEN Jiong2; CHEN Long3; ZHAO Shijie3
- 1. Department of Otolaryngology, Women and Children Health Care Hospital of Guangxi Zhuang Autonomous Region, Nanning 530003, China; 2. Radiological Center, the Third Affiliated Hospital of Guangxi Medical University, Nanning 530003, China; 3. Department of Otolaryngology, the Third Affiliated Hospital of Guangxi Medical University, Nanning 530003, China
- Keywords:
- ; Keywords: rhinosinusitis; nasal polyps; computed tomography; low dose radiation; complications; anatomy; endoscopic sinus surgery
- PACS:
- R765.41；R814.42
- DOI:
- DOI:10.3969/j.issn.1005-202X.2017.11.011
- Abstract:
- Abstract: Objective To compare identification of the surgically relevant anatomical structures via low- and standard-dose multi-slice spiral CT examination in patients with high-risk chronic rhinosinusitis (CRS) (i.e. presence of bronchial asthma, history of sinus surgery, advanced nasal polyposis and anosmia), and to discuss its relevance with perioperative period of endoscopic sinus surgery. Methods A total of 205 adult CRS patients were randomly divided into standard-dose group (n=85) and low-dose CT group (n=120). The scanning images of the vital anatomical structures (anterior ethmoid artery, optic nerve, cribriform plate and lamina papyracea) were scored. Polyp sizes were quantified according to the Lildholdt’s scale and Sniffin’ Sticks test was used to evaluate olfactory function. Results The mean value of the effective radiation dose in standard-dose group was 10 times higher than that in low-dose group (0.785 mSv vs 0.078 mSv; P<0.001). Identification of lamina papyracea on low-dose scans was significantly worse in each subgroup as comparison with standard-dose group, and the same was the case with cribriform plates in patients with advanced polyposis and anosmia (P<0.05). Cribriform plates were the most poorly identified among all the structures on low-dose images. Identification of anterior ethmoid artery didn’t show any statistical differences between low-dose group and standard-dose group. The anterior ethmoid artery was scored as an average-defined structure and was the second indiscernible. Conclusion Low-dose CT examination before operation may not sufficiently identify the surgically relevant anatomical structures in CRS patients accompanied with bronchial asthma, advanced nasal polyps (Lildholdt’s scale>2), history of sinus surgery and anosmia. But for the patient without any high-risk factors, low-dose CT examination shows a comparable identification of sinonasal landmarks with standard-dose CT examination. The conditions of different patients should be comprehensively evaluated in surgical planning for minimizing the risk of complications.
Last Update: 2017-11-23