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13-07-2010 | Respiratory | Article

Low-dose CT best for identifying sinus lesions in asthmatic patients with rhinitis

Abstract

Free abstract

MedWire News: Low-dose computed tomography (CT) identifies more severe paranasal sinus (PS) lesions than does X-ray scanning in asthma patients with rhinitis, research shows.

Rafael Stelmach (University of São Paulo Medical School, Brazil) and colleagues explain that severe PS lesions increase the risk for asthma exacerbations and are associated with greater asthma severity.

Information on PS lesion severity is therefore important in guiding treatment for asthma patients with rhinitis.

To compare the effectiveness of low-dose CT and X-ray for identifying PS involvement, the researchers enrolled 91 patients with asthma and rhinitis.

All the participants underwent PS radiography and six to eight low-dose CT scans on the central region of the sphenoidal, ethmoidal, maxillary, and frontal sinuses.

In total, 85 (93.4%) patients showed radiological PS changes, such as mucosal thickening and opacification, on CT or radiography.

The proportion of normal results differed significantly between X-ray and CT for the frontal (80.2% vs 89.0%), ethmoidal (76.9% vs 63.7%), and sphenoidal (96.7% vs 70.3%) sinuses. Agreement between X-ray and CT was over 70% for the maxillary and frontal sinuses.

Simultaneous PS abnormalities were observed in 40.5% of patients on X-ray and 56.7% on CT.

The researchers also found that CT was more effective at identifying air-fluid level changes than X-ray.

Stelmach and team conclude in the Journal of Asthma: "Low-dose CT significantly showed larger number of normal PS results and diagnosed more severe PS lesions."

They add: "As the determination of true sinus severity lesion impacts in asthma control, low-dose CT may replace PS plain X-ray and conventional CT to support better clinical decisions."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen

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