The ability of panoramic radiography in assessing maxillary sinus inflammatory diseases

Purpose : To evaluate the relative diagnostic accuracy of panoramic radiography and Water's projection in maxillary sinus inflammatory diseases by comparing the radiodensities of the images with those of CT. Materials and Methods : Panoramic radiographs, Waters' projection, and CT images from 55 subjects (11O sinuses) were included in this retrospective study. The radiodensity of each maxillary sinus in panoramic radiography was recorded separately as upper and lower divided horizontally by hard palate. In Waters' projection, the overall sinus radiodensity was recorded. The CT images were considered as gold standard. Results : In panoramic radiography, 83 sinuses had same upper and lower radiodensity and 72 of these were consistent with those of CT, 26 sinuses had different upper and lower radiodensity and 15 of these, upper radiodensity was consistent with CT, the remaining 11, lower radiodensity was consistent with CT. One sinus had upper radiolucency with lower radiopacity and both were consistent with those of CT. Altogether 73 (66.4%) among 110 sinuses in panoramic radiography showed full agreement with CT, 26 (23.6%) showed partial agreement with CT. 9 sinuses had no lower image under the hard palate in panoramic radiography due to the smaller size of sinus. In Waters' projection, the radiodensity of 105 sinuses (95.5%) were consistent with that of CT. Conclusion : The panoramic radiography showed 90.0% of the sinus conditions fully or partially which may appear less accurate than that of Water's view (95.5%) but with more detailed information of the inferior part of sinuses. (Korean J Oral Maxillofac Radiol 2008; 38 : 209-13)