The accuracy of computed tomography in the diagnosis of chronic rhinosinusitis

Neil Bhattacharyya, Marvin P. Fried

Research output: Contribution to journalArticle

132 Scopus citations

Abstract

Objective: To determine the sensitivity, specificity, and diagnostic accuracy of paranasal sinus computed tomography (CT) in the diagnosis of chronic rhinosinusitis (CRS). Study Design: Prospective dual cohort study. Methods: One hundred seventy-one consecutive patients undergoing endoscopic sinus surgery for CRS were evaluated with CT and staged according to the Lund system. Histopathological findings from sinus specimens were reviewed and graded. A second contemporaneous control group of 130 patients undergoing CT of the sinus regions for other reasons but without a diagnosis of CRS was also staged. Sensitivity, specificity, and the receiver-operator characteristic were determined for the sinus CT in the diagnosis of CRS. Positive and negative predictive values were also computed. Results: In the disease-positive group of patients with CRS, the mean Lund score was 9.8 (95% confidence interval, 9.0-10.6). The mean inflammatory grade on histopathological study was 2.3 (range, 0-4). For the control group (without disease), the mean Lund score was 4.3 (95% confidence interval, 3.5-5.0). The AUC for the receiver-operator characteristic was 0.802 (P <.001). Selecting a Lund score cut-off value of greater than 2 as abnormal, the sinus CT exhibited sensitivity and specificity of 94% and 41%, respectively. Increasing the cut-off value to 4 changed the sensitivity and specificity to 85% and 59%, respectively. Conclusions: The paranasal sinus CT scan exhibits good sensitivity and above-average specificity for the diagnosis of CRS. When added to the history and physical findings, CT may add to the diagnostic accuracy of CRS.

Original languageEnglish (US)
Pages (from-to)125-129
Number of pages5
JournalLaryngoscope
Volume113
Issue number1
DOIs
StatePublished - Jan 1 2003

Keywords

  • Chronic rhinosinusitis
  • Computed tomogra
  • Diagnosis
  • Phy
  • Sensitivity
  • Specificity

ASJC Scopus subject areas

  • Otorhinolaryngology

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