Prevalence of Early Detection of Rhinosinusitis Patients Between Contrast and Non-Contrast CT

Abstract

Background: Rhinosinusitis is a prevalent inflammatory condition of the paranasal sinuses with substantial effects on patient well-being and productivity. Early diagnosis is critical to prevent chronicity and complications. While computed tomography (CT) is the preferred imaging modality, the comparative diagnostic yield of contrast versus non-contrast CT in early rhinosinusitis detection remains insufficiently explored. Objective: To evaluate the prevalence of early detection of rhinosinusitis using contrast and non-contrast paranasal sinus CT (PNSCT) and to assess the statistical association between specific CT findings and confirmed rhinosinusitis in symptomatic individuals. Methods: This cross-sectional observational study was conducted on 100 patients (n = 100) presenting with nasal obstruction, facial pain, or related sinonasal symptoms at the Radiology Department of Jinnah Hospital, Lahore, between April and September 2024. Adults aged >20 years were included, while patients with renal impairment, contrast allergy, or pregnancy were excluded. CT imaging was performed using a PHILIPS Brilliance 64-slice scanner. Radiological findings were recorded, and data were analyzed using SPSS v27. Chi-square tests assessed associations, with statistical significance set at p < 0.05. Ethical approval was obtained in accordance with the Helsinki Declaration, and informed consent was secured. Results: Rhinosinusitis was identified in 52 patients (52.0%). Among CT findings, antrochoanal polyps (15.0%), calcifications (19.0%), mucosal thickening (10.0%), and widening of the osteomeatal complex (9.0%) were frequently observed. A significant association was found between these findings and rhinosinusitis diagnosis (p = 0.028). Of 78 patients (78.0%) who underwent contrast-enhanced CT, 41 (52.6%) had rhinosinusitis; in the non-contrast group (n = 22), 11 patients (50.0%) tested positive. The comparison revealed no statistically significant difference in detection rates between contrast and non-contrast imaging (p = 0.832), suggesting comparable diagnostic performance. Conclusion: Both contrast and non-contrast PNSCT are effective in detecting early rhinosinusitis, with non-contrast CT offering similar diagnostic accuracy and greater clinical safety. Significant radiological correlates such as mucosal thickening and osteomeatal complex changes reinforce CT’s critical role in early diagnosis. These findings support non-contrast CT as a first-line diagnostic tool in clinical practice, optimizing resource use while ensuring early intervention.