光谱CT钙抑制成像技术在鼻窦炎评估中的应用

Evaluating nasosinusitis using calcium-suppressed technique in dual-layer detector computed tomography

目的探索双层探测器光谱CT的钙抑制(CaSupp)技术在鼻窦炎评估中的有效性和准确性,为鼻窦炎的临床诊断提供新的工具。方法回顾性收集2019年3月~2023年9月就诊于解放军总医院海南医院的鼻窦炎患者30例,患者在1周内行鼻窦光谱CT和MRI检查,30例患者6组鼻窦[上颌窦(左、右)、筛窦(左、右)、蝶窦、额窦],共纳入174个鼻窦。根据患者所行检查技术,将患者分为钙抑制组和MRI组;CaSupp组根据其钙抑制指数分为40、50、60钙抑制组,并对CaSupp图像和MRI图像进行定性诊断和定量分析。基于CaSupp图像及MRI图像对鼻窦炎进行定性诊断,并采用卡方检验进行一致性检验。基于不同的钙抑制图像和MR图像对同一患者相同部位的鼻窦黏膜厚度进行测量,采用Pearson法及组内相关系数进行可靠性检验。结果CaSupp图像显示阳性鼻窦(有炎症的鼻窦)151个,阴性鼻窦(无炎症的鼻窦)23个;MRI图像显示阳性鼻窦155个,阴性鼻窦19个;CaSupp图像与MRI图像对鼻窦炎的诊断差异无统计学意义(P>0.05)。CaSupp指数为40、50、60钙抑制组对鼻黏膜厚度的测量结果与MRI组具有相关性(P<0.001);组内相关系数分析证实其组内相关系数系数分别为0.947、0.847及0.920。结论双层探测器光谱CT钙抑制技术对鼻窦炎的定性诊断和定量分析具有较高价值,且CaSupp指数为40时钙抑制图像在定量分析上与MRI图像的相关性最高。基于光谱CT的钙抑制技术为鼻窦炎的临床诊断及评估提供一种简单、有效的新方法。

Objective To explore the effectiveness and accuracy of calcium-suppressed(CaSupp)technique in the evaluation of nasosinusitis based on dual-layer detector computed tomography,which would provide a new tool for the clinical diagnosis of nasosinusitis.Methods Thirty cases of nasosinusitis were retrospectively analyzed,who visited Hainan Hospital of PLA General Hospital from March 2019 to September 2023 and were examined by spectral CT and MRI within one week.The included sinuses of 30 patients[maxillary sinus(left,right),ethmoid sinus(left,right),sphenoid sinus,frontal sinus]were 174 sinuses,and 6 sinuses were removed because of its incomplete images.According to the examination technique,these sinuses were classified into CaSupp group and MRI group(n=174);CaSupp group was divided into CaSupp-I 40,CaSupp-I 50 and CaSupp-I 60 group based on CaSupp index,respectively.CaSupp images and MR images were performed with the qualitative and quantitative analysis.The qualitative diagnosis of the nasosinusitis was made based on CaSupp and MR images,and Chi-squared test was used for consistency test.Based on different calcium suppression images and MR images,the mucosa thickness of the paranasal sinus was measured in the same location of the same patient,and the Pearson method and intraclass correlation coefficient(ICC)were used for reliability evaluation.Results The CaSupp images presented 151 positive sinuses(sinuses with inflammation)and 23 negative sinuses(sinuses without inflammation);MR images showed 155 positive sinuses and 19 negative sinuses.There was no significant difference between CaSupp images and MR images in the diagnosis of sinusitis(χ2=0.433,P>0.05).Correlation analysis presented that the CaSupp groups(CaSupp-I 40,50 and 60)were significantly correlated with the MRI group in the measurement results of mucosal thickness(P<0.001);The analysis of ICC confirmed that ICCs were 0.947,0.847,and 0.920,respectively.Conclusion CaSupp technique based on the dual-layer detector computed tomography presented high value in the qualitative and quantitative diagnosis of nasosinusitis,and the CaSupp images had the highest correlation with MRI images in quantitative analysis when CaSupp-I was set as 40.CaSupp technique based on the spectral CT provided a new simple and effective tool for the clinical diagnosis and evaluation of nasosinusitis.