Computed tomographic pulmonary changes in patients with chronic rhinosinusitis

Objective:

To investigate whether patients with a diagnosis of chronic rhinosinusitis (CRS) show characteristic pulmonary changes on chest CT compared with a control group without sinusopathy.

Methods:

This retrospective, observational study included patients with and without a diagnosis of CRS who underwent CT examination of the lungs between 2012 and 2014. Two radiologists, who were blinded for the presence of CRS, reviewed the scans for the presence of any abnormalities consensually. The χ² test was used for correlative analysis, with a significance level of 0.05.

Results:

A total of 123 CT series (51.2% from male patients, mean age 41 ± 16 years) were reviewed, including those from 59 (48%) patients with a diagnosis of CRS. Patients with CRS were more likely than the control group to exhibit atelectasis, bronchiolectasis, centrilobular nodules and ground-glass opacities (all p < 0.05), with a significant predilection for middle lobe and lingular involvement observed (p < 0.001). Other abnormalities, such as bronchial wall thickening and air trapping, did not differ between groups.

Conclusion:

Atelectatic changes, ground-glass opacities, bronchiolectasis and centrilobular nodules are the most frequent abnormalities associated with CRS, with peculiar middle lobe and lingular involvement observed on chest CT examinations.

Advances in knowledge:

CRS is a frequent disorder that displays typical pulmonary changes at CT. The recognition of such findings can prevent patients with this condition from undergoing unnecessary investigations that might be based on the presence of the aforementioned radiological features.