Limited coronal CT: an alternative screening examination for sinonasal inflammatory disease

Area of Science:

• Radiology
• Otolaryngology
• Medical Imaging

Background:

• Coronal CT is the gold standard for evaluating sinonasal inflammatory disease.
• Clinicians often use less expensive plain film sinus series despite its limitations.
• A need exists for a cost-effective and accurate screening tool.

Purpose of the Study:

• To prospectively compare a limited four-slice coronal CT with conventional CT and plain film sinus series.
• To determine if a limited CT is a suitable alternative for screening sinonasal inflammatory disease.
• To assess the accuracy of limited CT in detecting various sinonasal pathologies.

Main Methods:

• Prospective study involving 25 patients.
• Comparison of limited coronal CT, conventional coronal CT, and plain film sinus series.
• Evaluation of disease presence, amount, and location, including mucosal thickening, opacification, and cysts.

Main Results:

• Limited CT agreed with conventional CT in 82% of sinus compartments.
• Plain film missed 37 instances of disease compared to limited CT, with 73% involving significant mucosal thickening.
• Limited CT underestimated localized mucosal thickening (≤3mm) and osteomeatal disease.

Conclusions:

• A limited coronal CT is a potentially lower-cost alternative for screening sinonasal inflammatory disease and is more accurate than plain film.
• The current limited CT protocol underestimates localized and osteomeatal disease, making it unsuitable for cancer evaluation or surgical planning.