Role of diffusion‐weighted imaging in the discrimination of purulent intrasinusal content: a retrospective study
Thomas Radulesco Ugo Scemama Julien Mancini Guy Moulin Patrick Dessi Justin Michel Arthur Varoquaux
First published: 06 June 2019 https://doi.org/10.1111/coa.13388
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/coa.13388
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Abstract
Objectives
The objective of this study was to analyze MRI with morphological (T1, T2) and diffusion sequences (DWI, b1000) in patients presenting non‐aggressive patterns of sinus opacity and operated on by Functional Endoscopic Sinus Surgery (FESS).
Design
A retrospective study.
Setting
Diffusion imaging in paranasal sinus pathology remains little known. To date, no imaging system is capable of determining the purulent content of a non‐enhanced sinus filling.
Participants
We included consecutive patients having undergone FESS in whom MRI of the paranasal sinuses were performed. Subjects were allocated to Case (pus) or Control (no pus) groups depending on sinus content found intraoperatively. FESS was performed for bacterial acute rhinosinusitis, acute exacerbations of chronic rhinosinusitis, non‐purulent sinusitis, naso‐sinusal polyposis, antro‐choanal polyp, isolated polyp, angiomatous polyp and eosinophilic fungal sinusitis. Tumors, mucoceles and fungus balls were excluded.
Main outcome measures
We analyzed T1, T2, b1000 and MRI sequences and ADC map.
Results
On univariate analysis, intermediate signal in T2 and high signal in b1000 were associated with Cases (p<0.001) as were low ADC values (p<0.001). The difference in mean ADC values between Cases and Controls were statistically significant (respectively 0.518 vs 2.041 x10‐3 mm2/sec, p<0.01). On multivariate analysis, MRI with ADC<0.725 x10‐3 mm2/sec and b1000_SI>brain were significantly associated with the Case group. MRI with b1000_SI< brain and ADC>1.450x10‐3 mm2/sec were significantly associated with the Control group.
Conclusions
Diffusion MRI offers extremely promising results regarding content characterization of infectious sinus diseases.
This article is protected by copyright. All rights reserved.
Thomas Radulesco Ugo Scemama Julien Mancini Guy Moulin Patrick Dessi Justin Michel Arthur Varoquaux
First published: 06 June 2019 https://doi.org/10.1111/coa.13388
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/coa.13388
ePDFPDFTOOLS SHARE
Abstract
Objectives
The objective of this study was to analyze MRI with morphological (T1, T2) and diffusion sequences (DWI, b1000) in patients presenting non‐aggressive patterns of sinus opacity and operated on by Functional Endoscopic Sinus Surgery (FESS).
Design
A retrospective study.
Setting
Diffusion imaging in paranasal sinus pathology remains little known. To date, no imaging system is capable of determining the purulent content of a non‐enhanced sinus filling.
Participants
We included consecutive patients having undergone FESS in whom MRI of the paranasal sinuses were performed. Subjects were allocated to Case (pus) or Control (no pus) groups depending on sinus content found intraoperatively. FESS was performed for bacterial acute rhinosinusitis, acute exacerbations of chronic rhinosinusitis, non‐purulent sinusitis, naso‐sinusal polyposis, antro‐choanal polyp, isolated polyp, angiomatous polyp and eosinophilic fungal sinusitis. Tumors, mucoceles and fungus balls were excluded.
Main outcome measures
We analyzed T1, T2, b1000 and MRI sequences and ADC map.
Results
On univariate analysis, intermediate signal in T2 and high signal in b1000 were associated with Cases (p<0.001) as were low ADC values (p<0.001). The difference in mean ADC values between Cases and Controls were statistically significant (respectively 0.518 vs 2.041 x10‐3 mm2/sec, p<0.01). On multivariate analysis, MRI with ADC<0.725 x10‐3 mm2/sec and b1000_SI>brain were significantly associated with the Case group. MRI with b1000_SI< brain and ADC>1.450x10‐3 mm2/sec were significantly associated with the Control group.
Conclusions
Diffusion MRI offers extremely promising results regarding content characterization of infectious sinus diseases.
This article is protected by copyright. All rights reserved.
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