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The Application of Opacification-Development Ratio Based on CT Scan for Diagnosing Pediatric Chronic Rhinosinusitis
Jun Zhang1, Anni Yang1, Tengyu Chen1
1Department of Otolaryngology, Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, Guangdong Province, People's Republic of China.
Insights
The opacification-development ratio (ODR) shows strong diagnostic potential for pediatric chronic rhinosinusitis on CT scans. This new ODR score is particularly effective in diagnosing young children, outperforming the traditional Lund-Mackay score.
Area of Science:
- Radiology
- Pediatric Otolaryngology
- Medical Imaging
Background:
- Pediatric chronic rhinosinusitis (CRS) diagnosis can be challenging using clinical symptoms alone.
- Computed tomography (CT) scans are frequently used but can yield high false-positive rates.
- Objective assessment tools are needed to improve diagnostic accuracy in children.
Purpose of the Study:
- To evaluate the diagnostic performance of the opacification-development ratio (ODR) for pediatric CRS.
- To compare the ODR with the established Lund-Mackay (LM) score in children.
- To determine the ODR's utility in different pediatric age groups.
Main Methods:
- Retrospective analysis of nasal CT scans from 1820 children aged 0-15 years.
- Calculation of the ODR and LM scores for each patient.
- Assessment of diagnostic accuracy using area under the receiver operating characteristic curve (AUC) and predictive values.
Main Results:
- A significant positive correlation was found between ODR and LM scores across all age groups.
- In children aged 0-15 years, ODR (AUC 0.7970) showed comparable diagnostic accuracy to LM (AUC 0.7719).
- ODR demonstrated significantly superior performance in children aged 0-4 years (p < 0.001), with high specificity (94.2%) at an optimal cut-off of 25.83.
Conclusions:
- The ODR is a valuable CT-based tool for diagnosing pediatric CRS.
- ODR shows particular diagnostic strength in younger children (0-4 years).
- The ODR may help improve diagnostic accuracy and reduce false positives in pediatric CRS evaluations.
Purpose:
To investigate the diagnostic potency of the opacification-development ratio (ODR) for pediatric chronic rhinosinusitis based on CT scanning.
Patients And Methods:
Children aged 0-15 years who underwent nasal CT scanning from August 2011 through July 2021 were included in the research. The area under receiver operating characteristic curve (AUC) and predictive value were used to assess the diagnostic accuracy of the ODR and Lund-Mackay score based on CT scanning.
Results:
A total of 1820 patients (217 in the positive symptom group and 1603 in the negative symptom group) who underwent CT scanning were included in the study. A significant positive correlation was observed between the ODR and the Lund-Mackay score in all age groups. In children aged 0-15 years, the AUC of the ODR and the Lund-Mackay score were 0.7970 and 0.7719, respectively (p > 0.05). The optimal cut-off value for the ODR was 25.83, with a sensitivity of 57.14% and a specificity of 94.2%. In contrast, the optimal cut-off value for the Lund-Mackay score was 6.5, with a sensitivity of 6.5% and a specificity of 85.84%. Notably, the ODR score demonstrated significantly superior performance compared to the Lund-Mackay score in children aged 0-4 years (p < 0.001).
Conclusion:
In diagnosing pediatric chronic rhinosinusitis, the use of CT scans is associated with a higher rate of false positives when compared to clinical symptoms. The ODR score based on CT scanning is a valuable diagnostic tool for chronic rhinosinusitis in children aged 0-11, particularly those aged 0-4.
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