1600例马鼻窦疾病计算机断层扫描表现及其与病例结局的关联

文献信息

中文摘要

背景： 尚无研究描述过大量转诊鼻窦疾病病例队列的计算机断层扫描（CT）鼻窦表现。
目的： 报告马鼻窦疾病的CT影像学表现，并探讨病例结局与CT表现之间的关联。
研究设计： 回顾性病例系列。
方法： 从19家马医院收集接受过CT成像的鼻窦疾病病例的医疗记录数据。病例结局通过临床记录和/或联系畜主及转诊兽医获得。采用多变量logistic回归分析来检验就诊时与病例结局相关的变量。
结果： 1600例鼻窦疾病病例中，单侧鼻窦炎1457例，双侧鼻窦疾病143例。最常受累的是吻侧上颌窦（86.1%受累）和腹侧鼻甲窦（74.8%受累）。腹侧鼻甲泡（NCB）的液体衰减或变形分别见于21.3%和39.3%的病例，背侧NCB则分别见于16.5%和28.4%的病例。鼻窦相关骨的骨质增生（炎性增厚）在35.5%的病例中为轻度，19.8%为中度，8.7%为重度，36.1%为无。共发现659颗未骨折和200颗骨折的根尖感染牙齿。100匹马的正常对侧鼻窦在CT上显示114颗颊齿存在牙髓/根尖感染证据。多变量模型基于674例病例的数据构建。根尖感染未骨折牙齿（比值比[OR] 2.15，95%置信区间[CI] 1.41-3.29）或骨折牙齿（OR 2.03，95% CI 1.08-3.81）（即牙源性鼻窦炎）的病例治愈可能性高于无此类情况的病例。尾组鼻窦炎（OR 0.48，95% CI 0.29-0.80）或中度至重度骨骨质增生（OR 0.53，95% CI 0.36-0.78）的病例治愈可能性低于无此类情况的病例。
主要局限性： 回顾性研究，部分病例数据不完整。
结论： 上颌颊齿牙髓/根尖感染并不总是引起鼻窦炎。鼻窦骨骨质增生和尾组鼻窦炎与较低的治愈可能性相关，而根尖感染与较高的治愈可能性相关。

英文摘要

BACKGROUND: No study has described the computed tomographic (CT) sinonasal findings in a large cohort of referred sinonasal disease cases.
OBJECTIVES: To report the CT imaging findings in equine sinonasal disease and examine associations between case outcome and CT findings.
STUDY DESIGN: Retrospective case series.
METHODS: Data were collected from medical records from 19 equine hospitals on sinonasal disease cases which had undergone CT imaging. Case outcome was obtained from clinical records, and/or by contacting clients and referring veterinarians. Multivariable logistic regression analysis was used to examine variables at presentation associated with case outcome.
RESULTS: The 1600 cases of sinonasal disease had unilateral sinusitis in 1457 and bilateral sinus disease in 143. The rostral maxillary sinuses (86.1% affected) and ventral conchal sinuses (74.8% affected) were most commonly involved. Fluid attenuation or distortion of the ventral nasal conchal bullae (NCB) was present in 21.3% and 39.3% of cases, respectively, and of the dorsal NCB, in 16.5% and 28.4% of cases, respectively. Hyperostosis (inflammatory thickening) of sinus-related bones was mild in 35.5%, moderate in 19.8%, severe in 8.7%, and absent in 36.1% of cases. A total of 659 non-fractured and 200 fractured apically infected teeth were found. The normal contralateral sinuses in 100 horses showed CT evidence of endodontic/apical infection in 114 cheek teeth. The multivariable model was built with data from 674 cases. Cases with apically infected non-fractured (odds ratio [OR] 2.15, 95% confidence interval [CI] 1.41-3.29) or fractured teeth (OR 2.03, 95% CI 1.08-3.81) (i.e., dental sinusitis) had a higher likelihood of cure than those that did not. Cases with caudal group sinusitis (OR 0.48, 95% CI 0.29-0.80) or moderate or severe bone hyperostosis (OR 0.53, 95% CI 0.36-0.78) had a lower likelihood of cure than those without.
MAIN LIMITATIONS: Retrospective study with incomplete data available for some cases.
CONCLUSIONS: Maxillary cheek teeth endodontic/apical infection does not always cause sinusitis. Sinus bone hyperostosis and caudal group sinusitis are associated with a lower likelihood of cure, whereas apical infections are associated with a higher likelihood of cure.