Computer-assisted staging of chronic rhinosinusitis correlates with symptoms.
Computer-assisted staging of chronic rhinosinusitis correlates with symptoms.
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DOI：
10.1002/alr.21499
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发表时间：
2015-07
影响因子：
6.4
通讯作者：
Pinto JM
中科院分区：
文献类型：
--
作者：
Garneau J;Ramirez M;Armato SG 3rd;Sensakovic WF;Ford MK;Poon CS;Ginat DT;Starkey A;Baroody FM;Pinto JM
慢性鼻-鼻窦炎（CRS）的Lund-Mackay（LM）分期系统与临床参数无关，可能是由于其粗糙的尺度。我们开发了一种“改良隆德麦凯”（MLM）系统，该系统使用3D计算机化方法来量化鼻窦粘膜炎症的体积，并试图确定MLM是否与症状和疾病特异性生活质量相关。我们在鼻窦成像前即刻获得了55名成人受试者的总鼻症状评分（TNSS）和鼻窦结局测试（SNOT-22）数据。在手动勾画每个鼻窦轮廓后，使用定制的图像分析软件创建的MATLAB算法测量粘膜炎症占据的每个鼻窦的体积。使用线性回归来模拟MLM与SN 0 T-22和TNSS之间的关系。使用斯皮尔曼等级相关系数检验LM和MLM之间的相关性。根据年龄、性别和吸烟情况调整后，MLM发现，较高的症状负担与鼻窦炎症增加相关（β=0.453，p<0.013）。正如预期的那样，由于量表的差异，LM和MLM评分存在显著差异（p<0.011）。MLM和SNOT-22评分之间没有发现关联。MLM是第一个与鼻窦症状相关的基于成像的评分系统之一。这种定制软件的进一步开发，包括在更大样本中的完全自动化和验证，可能会产生一种对患者治疗和临床试验结果评估都有很大用处的生物标志物。
The Lund-Mackay (LM) staging system for Chronic Rhinosinusitis (CRS) does not correlate with clinical parameters, likely due to its coarse scale. We developed a “Modified Lund Mackay” (MLM) system, which uses a 3D, computerized method to quantify the volume of mucosal inflammation in the sinuses, and sought to determine whether the MLM would correlate with symptoms and disease-specific quality of life. We obtained Total Nasal Symptom Score (TNSS) and Sinonasal Outcomes Test (SNOT-22) data from 55 adult subjects immediately prior to sinus imaging. The volume of each sinus occupied by mucosal inflammation was measured using MATLAB algorithms created using customized, image analysis software after manual outlining of each sinus. Linear regression was used to model the relationship between the MLM and SNOT-22 and TNSS. Correlation between the LM and MLM was tested using Spearman's rank correlation coefficient. Adjusting for age, gender, and smoking, a higher symptom burden was associated with increased sinonasal inflammation as captured by the MLM (β=0.453, p<0.013). As expected due to the differences in scales, the LM and MLM scores were significantly different (p<0.011). No association between MLM and SNOT-22 scores was found. The MLM is one of the first imaging-based scoring systems that correlates with sinonasal symptoms. Further development of this custom software, including full automation and validation in larger samples, may yield a biomarker with great utility for both treatment of patients and outcomes assessment in clinical trials.