Olaf Sommerburg1,2,3, Mark O Wielpütz2,3,4, Jan-Philipp Trame2,3,4, Felix Wuennemann2,3,4, Elzbieta Opdazaite2,3,4, Mirjam Stahl1,2,5, Michael U Puderbach2,3,4, Annette Kopp-Schneider6, Eva Fritzsching1, Hans-Ulrich Kauczor2,3,4, Ingo Baumann7, Marcus A Mall1,2,5,8,9, Monika Eichinger2,3,4. 1. Division of Pediatric Pulmonology & Allergy and Cystic Fibrosis Center, Department of Pediatrics. 2. Translational Lung Research Center, German Lung Research Center. 3. Department of Diagnostic and Interventional Radiology. 4. Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik. 5. Department of Translational Pulmonology, and. 6. Department of Biostatistics, German Cancer Research Center, Heidelberg, Germany. 7. Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, Heidelberg, Germany. 8. Department of Pediatric Pulmonology, Immunology, and Intensive Care Medicine, Charité University Hospital Berlin, Berlin, Germany; and. 9. Berlin Institute of Health, Berlin, Germany.
Abstract
Rationale: Chronic rhinosinusitis (CRS) contributes to disease burden of patients with cystic fibrosis (CF). However, its onset and progression in infants and preschool children with CF remain poorly understood. Objectives: To determine the prevalence and extent of CRS in young children with CF using magnetic resonance imaging (MRI). Methods: MRI was performed in sedation in 67 infants and preschool children with CF (mean age 2.3 ± 2.1 yr; range 0-6 yr) and 30 non-CF control subjects (3.5 ± 2.0 yr; range 0-6 yr). Paranasal sinus dimensions and structural abnormalities, including mucosal swelling; mucopyoceles; and nasal polyps of the maxillary, frontal, sphenoid, and ethmoid sinuses; and, in addition, medial maxillary sinus wall deformation, were assessed using a dedicated CRS MRI scoring system. Results: Pneumatization and dimensions of paranasal sinuses did not differ between the two groups. MRI detected an increased prevalence of mucosal swelling (83% vs. 17%; P < 0.001), mucopyoceles (75% vs. 2%; P < 0.001), polyps (26% vs. 7%; P < 0.001), and maxillary sinus wall deformation (68% vs. 2%; P < 0.001) in infants and preschool children with CF compared with age-matched control subjects. Furthermore, the extent of these abnormalities was also increased with a MRI sum score of 22.9 ± 10.9 in CF compared with 4.5 ± 7.6 in non-CF control subjects (P < 0.001).Conclusions: MRI detected normal dimensions of paranasal sinuses, and a high prevalence and severity of paranasal sinus abnormalities due to CRS in infants and preschool children with CF without radiation exposure. Our results support the development of MRI for sensitive noninvasive diagnosis and monitoring of CRS in young children with CF, and as outcome measures for clinical trials.Clinical trial registered with www.clinicaltrials.gov (NCT00760071).
Rationale: Chronic rhinosinusitis (CRS) contributes to disease burden of patients with cystic fibrosis (CF). However, its onset and progression in infants and preschool children with CF remain poorly understood. Objectives: To determine the prevalence and extent of CRS in young children with CF using magnetic resonance imaging (MRI). Methods: MRI was performed in sedation in 67 infants and preschool children with CF (mean age 2.3 ± 2.1 yr; range 0-6 yr) and 30 non-CF control subjects (3.5 ± 2.0 yr; range 0-6 yr). Paranasal sinus dimensions and structural abnormalities, including mucosal swelling; mucopyoceles; and nasal polyps of the maxillary, frontal, sphenoid, and ethmoid sinuses; and, in addition, medial maxillary sinus wall deformation, were assessed using a dedicated CRS MRI scoring system. Results: Pneumatization and dimensions of paranasal sinuses did not differ between the two groups. MRI detected an increased prevalence of mucosal swelling (83% vs. 17%; P < 0.001), mucopyoceles (75% vs. 2%; P < 0.001), polyps (26% vs. 7%; P < 0.001), and maxillary sinus wall deformation (68% vs. 2%; P < 0.001) in infants and preschool children with CF compared with age-matched control subjects. Furthermore, the extent of these abnormalities was also increased with a MRI sum score of 22.9 ± 10.9 in CF compared with 4.5 ± 7.6 in non-CF control subjects (P < 0.001).Conclusions: MRI detected normal dimensions of paranasal sinuses, and a high prevalence and severity of paranasal sinus abnormalities due to CRS in infants and preschool children with CF without radiation exposure. Our results support the development of MRI for sensitive noninvasive diagnosis and monitoring of CRS in young children with CF, and as outcome measures for clinical trials.Clinical trial registered with www.clinicaltrials.gov (NCT00760071).
Entities:
Keywords:
chronic rhinosinusitis; cystic fibrosis; early diagnosis; magnetic resonance imaging; paranasal sinus
Authors: Erick Forno; Steven H Abman; Jagdev Singh; Mary E Robbins; Hiran Selvadurai; Paul T Schumacker; Paul D Robinson Journal: Am J Respir Crit Care Med Date: 2021-08-01 Impact factor: 30.528