A new score for tomographic opacification of paranasal sinuses in children

Abstract

Many score methods have been created to measure paranasal sinus abnormalities seen under CT scan. Currently, the Lund-Mackay staging system is widely accepted. However, its results may be affected by the development in children.

Aim: To assess the precision and accuracy of a new tomography score, called "opacification-development ratio". It translates the percentage of sinus area that is opaque.

Materials and methods: A cross-sectional study was prospectively conducted in patients ranging from 0-18 years of age who underwent CT scan assessment of rhinosinusitis. Two independent radiologists examined each scan twice, using both the Lund system and the ratio herein proposed.

Results: The opacification-development ratio reached substantial intra and inter-examiner agreement, similar to the Lund system (Kappa > 0.60). Considering the Lund system as the gold standard, the most accurate cut-off point was approximately 15 (sensitivity and specificity approach 90%). There was a strong linear correlation between the two methods (r > 90).

Conclusions: opacification-development ratio is precise and correlates with the Lund system. A cut-off point set at 15 could be used to call a test positive.

Chart 1

Distribution of the sample per category for each score (%). - LMS: Lund-Mackay system; ODR: opacification/development ratio

Chart 2

Linear regression between scales of two scores

Chart 3

Receiver Operator Characteristic curve for the opacification/ development ratio. Lund-Mackay system (LMS) as the reference test (positive = 4). - ODR: opacification/development ratio