Evaluating nasosinusitis using calcium-suppressed technique in dual-layer detector computed tomography
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 (x2=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.