Value of Hounsfield Units in the Evaluation of Isolated Sphenoid Sinus Lesions

Overview

Journal Allergy Rhinol (Providence)

Publisher Sage Publications

Specialty Allergy & Immunology

Date 2021 Aug 30

PMID 34457372

Authors

Orhan Tunc

Alper Yazici

Ismail Aytac

Koray Tumuklu

Melih Aksamoglu

Affiliations

Soon will be listed here.

Abstract

Radiologic findings of fungal sinus disease are generally opacification in paranasal computed tomography (CT) images. The Hounsfield unit (HU) is a standardized objective unit that is also suitable for measuring remodeling and opacifications on CT scans of bone sections of patients with chronic rhinosinusitis. We hypothesized that HU values could provide valuable information in isolated sphenoid sinus lesions before surgery. Between 2012 and 2019, 35 patients underwent functional endoscopic sinus surgery for sphenoid sinus lesions. Tissues obtained from the sphenoid sinus were divided into two groups, fungal and nonfungal, according to the findings of histopathologic examinations. HU values were measured in sphenoid sinus sections on paranasal CT scans of these two groups. Differences in mean and maximum HU values between the two groups were statistically significant (<.05). The maximum HU values calculated from the sphenoid sinus were 435.08 and 196.23 (≤.05) in the fungal group and nonfungal group, respectively. The mean HU values calculated from the sphenoid sinus were 64.31 and 29 (≤.05) in the fungal and nonfungal groups, respectively. At the maximum cutoff value of 241, the sensitivity and specificity of the HU maximum were 84.6% and 77.3%, respectively. At the mean cutoff value of 41.5, the sensitivity and specificity of the HU mean were 76.9% and 86.4%, respectively. HU is an objective value used in radiographic density measurement. The HU values were higher in fungal lesions than in nonfungal inflammations, and they are useful in preoperative measurement.

References

Killeen D, Sedaghat A, Cunnane M, Gray S . Objective radiographic density measurements of sinus opacities are not strong predictors of noninvasive fungal disease. Am J Rhinol Allergy. 2014; 28(6):483-6. DOI: 10.2500/ajra.2014.28.4104. View

Friedman A, Batra P, Fakhri S, Citardi M, Lanza D . Isolated sphenoid sinus disease: etiology and management. Otolaryngol Head Neck Surg. 2005; 133(4):544-50. DOI: 10.1016/j.otohns.2005.04.023. View

Erlebacher A, Filvaroff E, Gitelman S, Derynck R . Toward a molecular understanding of skeletal development. Cell. 1995; 80(3):371-8. DOI: 10.1016/0092-8674(95)90487-5. View

Nicolai P, Mensi M, Marsili F, Piccioni M, Salgarello S, Gilberti E . Maxillary fungus ball: zinc-oxide endodontic materials as a risk factor. Acta Otorhinolaryngol Ital. 2015; 35(2):93-6. PMC: 4443559. View

Lim H, Yoon Y, Xu J, Kim Y, Rha K . Isolated sphenoid sinus fungus ball: a retrospective study conducted at a tertiary care referral center in Korea. Eur Arch Otorhinolaryngol. 2017; 274(6):2453-2459. DOI: 10.1007/s00405-017-4468-0. View

Moss W, Finegersh A, Jafari A, Panuganti B, Coffey C, DeConde A . Isolated sphenoid sinus opacifications: a systematic review and meta-analysis. Int Forum Allergy Rhinol. 2017; 7(12):1201-1206. DOI: 10.1002/alr.22023. View

Razek A, Sieza S, Maha B . Assessment of nasal and paranasal sinus masses by diffusion-weighted MR imaging. J Neuroradiol. 2009; 36(4):206-11. DOI: 10.1016/j.neurad.2009.06.001. View

Eloy P, Grenier J, Pirlet A, Poirrier A, Stephens J, Rombaux P . Sphenoid sinus fungall ball: a retrospective study over a 10- year period. Rhinology. 2013; 51(2):181-8. DOI: 10.4193/Rhino12.114. View

Park M, Rah Y, Kim Y, Kim J . Usefulness of computed tomography Hounsfield unit density in preoperative detection of cholesteatoma in mastoid ad antrum. Am J Otolaryngol. 2010; 32(3):194-7. DOI: 10.1016/j.amjoto.2010.01.008. View

10.

Cho S, Min H, Han H, Paik S, Kim K . CT analysis and histopathology of bone remodeling in patients with chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2006; 135(3):404-8. DOI: 10.1016/j.otohns.2006.04.005. View

11.

Basmaci I, Sefik E . A novel use of attenuation value (Hounsfield unit) in non-contrast CT: diagnosis of pyonephrosis in obstructed systems. Int Urol Nephrol. 2019; 52(1):9-14. DOI: 10.1007/s11255-019-02283-2. View

12.

Emre I, Celebi I, Ercan I . The radiologic evaluation of osteitis type and formation in chronic rhinosinusitis with and without nasal polyposis. Am J Rhinol Allergy. 2015; 29(6):e201-4. DOI: 10.2500/ajra.2015.29.4240. View

13.

Khalid A, Hunt J, Perloff J, Kennedy D . The role of bone in chronic rhinosinusitis. Laryngoscope. 2002; 112(11):1951-7. DOI: 10.1097/00005537-200211000-00008. View

14.

Snidvongs K, Sacks R, Harvey R . Osteitis in Chronic Rhinosinusitis. Curr Allergy Asthma Rep. 2019; 19(5):24. DOI: 10.1007/s11882-019-0855-5. View

15.

Ishihara H, Oka F, Kawano R, Shinoyama M, Nishimoto T, Kudomi S . Hounsfield Unit Value of Interpeduncular Cistern Hematomas Can Predict Symptomatic Vasospasm. Stroke. 2019; 51(1):143-148. DOI: 10.1161/STROKEAHA.119.026962. View

16.

Lee J, Kennedy D, Palmer J, Feldman M, Chiu A . The incidence of concurrent osteitis in patients with chronic rhinosinusitis: a clinicopathological study. Am J Rhinol. 2006; 20(3):278-82. DOI: 10.2500/ajr.2006.20.2857. View

17.

Dong Y, Zhou B, Wang X, Huang Z, Wang M, Li Y . Computed tomography and histopathological evaluation of osteitis in rabbit models with rhinosinusitis. Acta Otolaryngol. 2016; 137(5):534-540. DOI: 10.1080/00016489.2016.1252060. View

18.

Krennmair G, Lenglinger F . Computed tomography (CT) in the diagnosis of sinus aspergillosis. J Craniomaxillofac Surg. 1994; 22(2):120-5. DOI: 10.1016/s1010-5182(05)80022-8. View

19.

Ilica A, Mossa-Basha M, Maluf F, Izbudak I, Aygun N . Clinical and radiologic features of fungal diseases of the paranasal sinuses. J Comput Assist Tomogr. 2012; 36(5):570-6. DOI: 10.1097/RCT.0b013e318263148c. View

20.

Tomazic P, Dostal E, Magyar M, Lang-Loidolt D, Wolf A, Koele W . Potential correlations of dentogenic factors to the development of clinically verified fungus balls: A retrospective computed tomography-based analysis. Laryngoscope. 2015; 126(1):39-43. DOI: 10.1002/lary.25416. View