Evaluation of Ultrasound Efficiency in the Diagnosis of Acute Maxillary Sinusitis in Comparison with CT Scan Findings in Children Aged 5 to 15 Years
Author(s): Elham Zarei, Seyed Morteza Bagheri, Aydin Tadayon
Abstract
Acute maxillary sinusitis in children is diagnosed often based on the patient's clinical findings. However, imaging is required in many cases due to overlap of signs and symptoms. CT scan is nowadays used as a radiologic Gold Standard. Ultrasound, as a diagnostic method, has been less studied and the results of studies have also been different. This study evaluates the diagnostic accuracy of ultrasound compared to that of CT scan in diagnosing acute maxillary sinusitis in children. This is a cross-sectional study. The inclusion criterion of study was 5 to 15 years of old children, underwent paranasal sinuses CT scans with suspected acute rhinosinusitis clinically, to confirm the diagnosis. Exclusion criteria included presence of other sinus pathologies such as polyp and retention cyst. All patients underwent maxillary sinus ultrasound within 24 hours of CT scan. The findings of ultrasound and CT scan were classified as opacification (Op), mucosal thickening (MT) and normal. The DTComPair package under the R software was used for analysis and calculations. In addition, level of agreement between the two modalities was determined using CAPA statistical index. Results: given the exclusion criteria, 50 patients, including 22 female and 28 male patients with mean age of 7.14 ± 2.98 were included into study. Subjects with 100% maxillary sinus underwent ultrasound. The sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound were determined 92%, 88%, 92%, and 88%, respectively. The level of ultrasound error was low in diagnosing normal and opacification cases but high in diagnosing mucosal thinning (41.7%). Ultrasound is a reliable method for diagnosis of acute maxillary sinusitis, while this modality shows a high level of error in diagnosing mucosal thickening.
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