Imaging in chronic rhinosinusitis: A systematic review of MRI and CT diagnostic accuracy and reliability in severity staging - 06/02/21

Doi : 10.1016/j.neurad.2021.01.010

Tomislav Gregurić ^a, Emmanuel Prokopakis ^b, Ioannis Vlastos ^b, Maria Doulaptsi ^b, Cemal Cingi ^c, Andro Košec ^d,⁎ , Dijana Zadravec ^a, Livije Kalogjera ^d
^a Department of Diagnostic and Interventional Radiology, University Hospital Centre “Sestre milosrdnice”, Zagreb, Croatia
^b Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
^c Department of Otolaryngology, Head and Neck Surgery, Eskişehir Osmangazi University, Eskisehir, Turkey
^d Department of ORL/Head and Neck Surgery, Zagreb School of Medicine, University Hospital Centre “Sestre milosrdnice”, Zagreb, Croatia

^⁎Corresponding author at: Department of Otorhinolaryngology and Head and Neck Surgery, School of Medicine, University of Zagreb, University Hospital Center Sestre milosrdnice, Zagreb, Croatia.Department of Otorhinolaryngology and Head and Neck SurgerySchool of MedicineUniversity of ZagrebUniversity Hospital Center Sestre milosrdniceZagrebCroatia

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Saturday 06 February 2021
This article has been published in an issue click here to access

Graphical abstract

El texto completo de este artículo está disponible en PDF.

Highlights

•	CT is the most commonly used imaging technique for the severity staging of CRS
•	This review included 21 studies concerned with CT and/or MRI imaging in CRS diagnostic accuracy and/or severity staging
•	MRI may be a complementary staging tool when repeated examinations are required
•	MRI may be utilized as a staging tool, using the same staging systems as with CT

El texto completo de este artículo está disponible en PDF.

Abstract

Background

Computerized tomography (CT) severity scores are frequently used as an objective staging tool in chronic rhinosinusitis (CRS). Magnetic resonance imaging (MRI) has also been proposed as a valid option in CRS imaging.

Purpose

The aim of this systematic review was to briefly present the recent developments on sinus imaging utilized in clinical practice with regard to diagnostic accuracy of imaging and severity staging in CRS according to evidence-based medicine (EBM) principles.

Material and Methods

This review paper has been assembled following PRISMA guidelines. A PubMed and Scopus (EMBASE) search using CRS, „severity staging“, „diagnostic accuracy “and „imaging “resulted with 80 results. Of these, only 12 (59%) contained original data, constituting the synthesis of best-quality available evidence.

Results

CT is the most commonly used imaging technique for the severity staging of CRS, but a question of higher cumulative radiation dose should be taken into consideration when repeating CT examinations in evaluating treatment efficacy. MRI may be a complementary diagnostic and staging tool, especially when repeated examinations are required, or when paediatric CRS patients are evaluated. The severity staging system may be improved to better correlate with subjective scores.