Diagnostic accuracy of computed tomography compared to histopathology in the diagnosis of paranasal sinus diseases

Background: Paranasal sinus diseases include inflammatory, neoplastic, and nonneoplastic processes. Computed tomography (CT) is used for preoperative evaluation. CT is very useful for visualization of bone structures. Objectives: The objective of this study was to evaluate the accuracy of CT findings for sinusitis and other sinonasal pathologies using histopathology as a gold standard. To outline the radiological findings of sinonasal pathologies. Materials and Methods: This prospective study is a hospital-based diagnostic test evaluation. The subjects included 80 patients suspected of having paranasal sinus disease. The duration of study is 1 year. All patients underwent 16-slice CT scanning. The findings were correlated with histopathology, and the findings were compared. The accuracy of CT findings for sinusitis and other pathologies was calculated. Results: A total of 80 patients were analyzed. Polyp was the most frequent diagnosis on CT ( n = 32, 40.0%), followed by chronic sinusitis ( n = 26, 32.5%), fungal sinusitis ( n = 10, 12.5%), and malignancy ( n = 6, 7.5%). CT findings were highly accurate compared to histopathology. The sensitivity and specificity of CT for chronic sinusitis (86.4% and 93.6%), fungal sinusitis (40.0% and 97.1%), polyp (87.9% and 93.6%), malignancy (83.3% and 98.6%), inverted papilloma (66.7% and 98.7%), and juvenile nasopharyngeal angiofibroma (100.0% and 100.0%) were statistically significant ( P < 0.0001). Conclusion: CT is a reliable investigation for sinusitis and other related pathologies. It is very useful for visualizing bones. However, it is not very useful for differentiating hyperdense material such as fungal concretions and inspissated secretions, where CT features may overlap with other pathologies.