Three-dimensional image analysis for staging chronic rhinosinusitis.
Three-dimensional image analysis for staging chronic rhinosinusitis.
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DOI：
10.1002/alr.22014
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发表时间：
2017-11
影响因子：
6.4
通讯作者：
Pinto JM
中科院分区：
文献类型：
--
作者：
Lim S;Ramirez MV;Garneau JC;Ford MK;McKeough K;Ginat DT;Baroody FM;Armato SG 3rd;Pinto JM
通过成像对慢性鼻窦炎（CRS）进行分期的传统方法不能区分部分粘膜鼻窦炎症的程度，因此限制了其作为成像生物标志物的实用性。我们假设，软件辅助的鼻窦炎症定量测量将生成与疑似鼻窦疾病患者的临床参数相关的疾病负担指标。在城市、学术、三级医疗中心招募接受CT成像的有神经系统疾病主诉的成人（n=45，Lund-Mackay [LM]评分≥ 4）。使用半自动化方法进行3D体积图像分析，以获得“芝加哥改良Lund-Mackay”（芝加哥MLM）评分，该评分提供了量化浑浊程度的连续量表。使用线性回归检验芝加哥MLM评分与并发症状（总鼻部症状评分[TNSS]）和疾病特异性生活质量（鼻窦结局测试-22 [SNOT 22]）的相关性。芝加哥MLM评分与症状（p=0.037）和疾病特异性生活质量（p=0.007）显著相关。筛窦和蝶窦的炎症似乎影响这些联系。当分析仅限于患有更严重疾病（LM>6）的患者时，这些发现甚至更可靠。通过计算机辅助3D分析定量测量鼻窦炎症与症状和疾病特异性生活质量适度相关。后窦似乎对这些结果的影响最大，可能为临床医生提供基础治疗的解剖靶点。芝加哥MLM评分是一种有前途的临床和研究用途的成像生物标志物。
Traditional methods of staging chronic rhinosinusitis (CRS) through imaging do not differentiate between degrees of partial mucosal sinus inflammation, thus limiting their utility as imaging biomarkers. We hypothesized that software-aided, quantitative measurement of sinus inflammation would generate a metric of disease burden that would correlate with clinical parameters in patients with suspected sinus disease. Adults with rhinologic complaints undergoing CT imaging were recruited at an urban, academic, tertiary care center (n=45 with Lund-Mackay [LM] scores ≥ 4). 3D volumetric image analysis was performed using a semi-automated method to obtain a “Chicago-modified Lund-Mackay” (Chicago MLM) score, which provides a continuous scale to quantify extent of opacification. Linear regression was used to test the association of the Chicago MLM score with concurrent symptoms (total nasal symptom scores [TNSS]) and disease-specific quality of life (Sinonasal Outcome Test-22 [SNOT22]). Chicago MLM scores were significantly associated with both symptoms (p=0.037) and disease-specific quality of life (p=0.007). Inflammation in the ethmoid and sphenoid sinuses appeared to influence these associations. These findings were even more robust when analysis was limited to patients with more severe disease (LM>6). The quantitative measurement of sinus inflammation by computer-aided 3D analysis correlates modestly with both symptoms and disease-specific quality of life. Posterior sinuses appear to have the greatest impact on these findings, potentially providing an anatomic target for clinicians to base therapy. The Chicago MLM score is a promising imaging biomarker for clinical and research use.
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