Методика ультразвукового сканирования верхнечелюстной и лобной пазух

Abstract

Background: Ultrasonography can be used as an alternative to radiographic survey in diagnosis of sinusitis. Material and methods: The study involved 150 patients with acute and chronic inflammation of maxillary and frontal sinuses, in all patients ultrasound and x-ray examinations have been performed, followed by puncture of the maxillary sinuses. The ultrasound examination was performed by two probes: linear and micro-convex. For each diagnostic technique the sensitivity, specificity and accuracy were calculated. As the gold standard diagnostic puncture of the maxillary sinus (in most cases), computed tomography and intraoperative findings were adopted. For pairwise comparison of the characteristics of different methods the z-test was used. It was considered statistically significant (p < 0.05). Results: X-ray examination turned out to produce erroneous results in a high percentage of cases while detecting fluid in sinuses, if fluid level fails to be discovered on radiograms. High accuracy of ultrasound examination in detecting fluid and its nature (pus, serous exudate) is identified for scanning with both linear and micro-convex transducers. But sensitivity of the micro-convex transducer is higher (96.9%) than that of linear one (83.0%) in detecting fluid. In diagnosis of edema, a higher percentage of errors (false-positive results) were revealed in case of the micro-convex transducer (39.3%), and a lower rate – for linear transducer (3.6%). Accuracy in detecting mucosal thickening for X-ray was 66.7%, B-linear – 87.2%, B-micro-convex – 84.3%. Accuracy in detecting fluid for X-ray was 65.8%, B-linear – 86.1%, B-micro-convex – 96.6%. Conclusions: 1. Results showed that ultrasound diagnosis of inflammatory disease of the maxillary and frontal sinuses can be used as a screening method for diagnosis on a par with radiographic survey. 2. There is a significant difference between the study methods in accuracy of edema and fluid detection in favor of ultrasound diagnosis. 3. To improve the quality of ultrasound technique, combined survey with two probes (linear and micro-convex) should be used. Linear probe is appropriate for detecting mucosal thickening, and micro-convex one – for fluid detection.