Article Figures & Data
Figures
- FIG 1.
A 28-year-old woman with eosinophilic granulomatosis with polyangiitis. A and B, Axial paranasal sinus CT images show high-density sinus opacifications in both maxillary and left sphenoidal sinuses and low-density nasal polyps in both nasal cavities. HU of high-density materials in the right maxillary, left maxillary, and left sphenoid sinuses are 66.7, 70.0, and 69.2, respectively. C, Coronal paranasal sinus CT image shows high-density materials in both maxillary sinuses and low-density nasal polyps in both nasal cavities.
FIG 2. A and B, A 25-year-old woman with eosinophilic granulomatosis with polyangiitis. C and D, A 48-year-old man with granulomatosis with polyangiitis. A, Axial paranasal sinus CT image shows high-density sinus opacifications in both maxillary sinuses and low-density nasal polyps in both nasal cavities. HU of high-density materials in the right and left maxillary sinuses are 91.6 and 91.5 (black circular ROIs), respectively. B, Coronal paranasal sinus CT images show high-density materials in both maxillary and ethmoidal sinuses and low-density nasal polyps in both nasal cavities. C, Axial paranasal sinus CT image with soft tissue algorithm shows internal low-density materials in both maxillary sinuses. HU of low-density materials in the right and left maxillary sinuses are 43.5 and 41.5 (white circular ROIs), respectively. D, Axial paranasal sinus CT image with bone algorithm shows destruction of the medial walls and diffuse sclerosis of the anterior and posterior walls of maxillary sinuses bilaterally.
- FIG 3.
A 53-year-old woman with granulomatosis with polyangiitis. Axial (A) and coronal (B) paranasal sinus CT images with bone algorithm show diffuse sclerotic wall thickening of left sphenoidal sinus wall with posterior wall destruction (A) and bone destructions in nasal septum and nasal turbinates (B). Axial paranasal sinus CT images with soft tissue algorithm show left maxillary sinusitis without internal high-density (C) and suspicious intracranial extension of soft tissue attenuation lesion in the left sphenoidal sinus (D).
Tables
Group GPA (n = 31) EGPA (n = 22) Age mean SD (years) 50.1 ± 20 50.8 ± 13.6 Sex (M:F) 15:16 13:9 ANCA status c-ANCA 20 0 p-ANCA 2 6 Both c-, p-ANCA 1 0 Negative 8 13 N/A 0 3 Eosinophil Eosinophilia (>8%) 1 20 Normal 30 0 N/A 0 2 Note:—SD indicates standard deviation; ANCA, antineutrophil cytoplasmic antibody; N/A, not available.
GPA (n = 31) EGPA (n = 22) P HU (mean ± SD) 44.4 ± 20.2 77.8 ± 31.9 < .0001 High-density component (present:absent) 5:26 16:6 < .0001 Bone destruction .006 Nasal septum 7 2 Nasal septum + sinus wall 4 0 Nasal septum + sinus wall + orbital wall 2 0 Sinus wall + orbital wall + skull base 1 0 None 17 20 Sclerotic change (present:absent) 16:15 5:17 .048 Organ involvement .035 Orbit 3 0 Nasolacrimal duct 1 0 Orbit + nasolacrimal duct 1 0 Intracranial extension 1 0 None 25 22 Nasal polyp (present: absent) 10: 21 10: 12 .333 LMS (mean ± SD) 10.1 ± 6.5 13.1 ± 6.3 .078 - Table 3:
Multiple logistic regression analysis with the presence of subjective high-density in the paranasal sinuses
Imaging Finding Coefficient (B) Standard Error P OR 95% CI High-density 3.983 1.316 .003 53.666 4.068–708.032 Bone destruction −2.481 1.35 .066 0.084 0.006–1.18 Sclerotic change −0.633 0.925 .494 1.884 0.307–11.552 Organ involvement −19.417 6640.508 .998 3.69E-09 0-Exp (12,995) LMS −0.071 0.085 .401 0.932 0.789–1.099 - Table 4:
Multiple logistic regression analysis with the mean HU of the highest-density portion in the paranasal sinuses
Imaging Finding Coefficient (B) Standard Error P OR 95% CI Mean HU 0.067 0.025 .005 1.072 1.021–1.125 Bone destruction −1.842 1.224 .132 0.159 0.014–1.746 Sclerotic change −0.033 0.877 .97 0.967 0.174–5.395 Organ involvement −20.672 6485.543 .998 1.05E-09 0-Exp (12,689.9) LMS −0.056 0.074 .45 0.945 0.817–1.094 - Table 5:
The diagnostic ability of each paranasal sinus CT finding in differentiation between GPA and EGPA
Imaging Finding AUROC 95% CI Sensitivity Specificity HU 0.777 0.642–0.88 72.7 90.3 High-density component 0.783 0.648–0.884 72.7 83.9 Bone destruction 0.68 0.538–0.802 90.9 45.2 Sclerotic change 0.644 0.501–0.771 77.3 51.6 Organ involvement 0.597 0.453–0.729 100 19.4
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