Hyperdense findings in sinus computed tomography of chronic rhinosinusitis.
BACKGROUND
Our study investigated the diagnostic value of the mineralization findings and high-density secretion features of sinus computed tomography (CT) images in cases of chronic rhinosinusitis (CRS) compared to histopathology and operative findings.


METHODS
This was a prospective cohort study of 193 patients consecutively enrolled for endoscopic sinus surgery (ESS). Group 1 had mineralization in the sinus; group 2 had high-density secretions in the sinus but no mineralization; group 3 lacked both high-density secretions and evidence of mineralization. Intergroup comparisons were performed for histopathology (especially presence of fungus ball), CT scores, and gross operative appearance.


RESULTS
Histopathologic evidence of fungus ball (FB) compared to presence of CT findings was significantly different between the groups, with the following percentages of patients demonstrating FB presence: 33% of group 1 (CT mineralization) (n = 48); 4% of group 2 (CT hyperdensity) patients (n = 25); and 2% of group 3 (no mineralization, no hyperdensity) patients (n = 120) (p < 0.05). Operative findings did not necessarily correlate with CT findings and all groups demonstrated varying amounts of dry cheesy (DCM) or wet clay-like (WCLM) material, though this was slightly higher in groups 1 and 2.


CONCLUSIONS
A preoperative survey of sinus mineralization and high-density secretion features observed with CT was predictive of operative findings and histopathological results indicating a sinus FB.
Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan.|School of Medicine, China Medical University, Taichung, Taiwan.
Teik-Ying
TY
Ng
Department of Health Services Administration, China Medical University, Taichung, Taiwan.
Jong-Yi
JY
Wang
Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan.|School of Medicine, China Medical University, Taichung, Taiwan.
Ming-Hsui
MH
Tsai
School of Medicine, China Medical University, Taichung, Taiwan.|Department of Radiology, China Medical University Hospital, Taichung, Taiwan.
Chao-Chun
CC
Lin
Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan.|School of Medicine, China Medical University, Taichung, Taiwan.|Department of Health Services Administration, China Medical University, Taichung, Taiwan.
Chih-Jaan
CJ
Tai
Department of Pharmacy, Changhua Christian Hospital, Chang Hua, Taiwan.
Yon-Keat
YK
Ng
D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000175:diagnosis* / Q000601:surgery; D002908:Chronic Disease; D015331:Cohort Studies; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000473:pathology*; D011446:Prospective Studies; D011859:Radiography; D012220:Rhinitis / Q000175:diagnosis* / Q000601:surgery; D012852:Sinusitis / Q000175:diagnosis* / Q000601:surgery
computed tomography; high-density secretion; mineralization; operative finding; rhinosinusitis; sinus fungus ball