In the imaging evaluation of chronic rhinosinusitis (CRS), assessment is typically based on the location and extent of sinus opacification; however, objective diagnostic indicators remain limited. This study was aimed at evaluating the clinical utility of quantitative computed tomography (CT) in distinguishing between eosinophilic chronic rhinosinusitis (ECRS) and non-eosinophilic CRS (non-ECRS). The study was conducted on a total of 45 patients who had undergone endoscopic sinus surgery (30 with ECRS, 15 with non-ECRS) and 15 control subjects. The Lund-Mackay scoring system was used to assess the degree of sinus opacification. The volume of each paranasal sinus and the soft tissue occupancy ratio of its contents were quantitatively analyzed using a CT image analysis software. For this purpose, the sinonasal cavities were segmented and reconstructed in 3D, and voxel-based CT values were analyzed using the “AttractiveTM” software. The CT values were categorized as follows: air, less than –701 Hounsfield units (HU); soft tissue, –700 to 99 HU, and bone, 100 HU or higher. The soft tissue occupancy ratio and ethmoid-to-maxillary sinus soft tissue ratio were calculated and compared among the groups.
Akao et al. (Thu,) studied this question.