Osteitis in Patients with Chronic Paranasal Sinusitis Evaluated by 99mTc-MDP bone SPECT

Jang, Yong Ju; Koo, Tae Woo; Park, Seok Gun; Chung, Phil Sang

Abstract

BACKGROUND AND OBJECTIVES: The objective of this study is to investigate the incidence and clinical implication of osteitis in patients with chronic paranasal sinusitis.
MATERIALS AND METHODS
Forty three patients diagnosed as chronic paranasal sinusitis were examined with 99mTc-MDP bone SPECT preoperatively and underwent endoscopic operation, and 6 volunteers were recruited and examined as a control group. Each SPECT image was semiquantitatively assigned one of three grades of 0, 1, 2 according to intensities of isotope uptake. Quantitative analysis of the uptake of the isotope was performed by computer. The incidence of osteitis was analyzed. The correlation between semiquantitative grades and quantitative uptake indices was evaluated, and degree of isotope uptake and the severity of mucosal pathology on CT was correlated. The degree of isotope uptake between the patients who had recurrence and had not was compared.
RESULTS
Quantitative evaluation of uptake indices were significantly higher in the patient group than in the control group. Marked uptakes of isotope on the sinus areas, suggesting the presence of osteitis, were shown in the patient group by 53.5%. The semiquantitative grades and quantitative indices showed positive correlation, and SPECT and CT scan findings also showed significant correlation. The uptake indices of patients who had recurrence were significantly higher than those of patients who showed no recurrence in both ethmoid sinus areas. CONCLUSIONS: The results of this study showed that significant proportion of patients with chronic paranasal sinusitis have osteitis, and patients with more severe osteitis represent poorer postoperative courses.