Differentiation of equine paranasal sinus cysts and progressive ethmoid haematomas on computed tomographic images.
Abstract: Paranasal sinus cysts (PSC) and progressive ethmoid haematomas (PEH) are regularly observed in the paranasal sinus system. Due to their different prognosis and treatment options, differentiation of both lesions prior to surgery on computed tomographic (CT) images is important for guidance. It was hypothesised that PSC and PEH can be reliably differentiated on CT images. The database of four European equine referral centres were retrospectively searched for horses that had undergone a CT examination of the head and had a confirmed PSC or PEH. Additionally, cases with confirmed sinusitis were selected as control cases. Images were anonymised and evaluated by different observers to investigate their ability to differentiate these diseases. Multiple imaging characteristics were evaluated for all diseases. Ninety-seven horses were included, final diagnosis was PEH in 24, PSC in 28, and sinusitis in 45 horses. Substantial to almost perfect agreement between CT diagnosis and final diagnosis for all three observers was found. Heterogeneity and attenuation of the lesion were graded significantly higher in PEH. Mineralisation within the soft tissue structure, inner and outer distortion of bone and soft tissues, a mineralised wall, and dental distortion were significantly more common in PSC. Only cases that subsequently underwent treatment were included, therefore, most cases were at an advanced stage. Histological examination was not available in all cases. Differentiation between PEH and PSC on CT images was excellent, and the reported different characteristics might help clinicians to distinguish between both diseases.
Copyright © 2025. Published by Elsevier Inc.
Publication Date: 2025-05-08 PubMed ID: 40345407DOI: 10.1016/j.jevs.2025.105609Google Scholar: Lookup
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Summary
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This research investigated how computed tomography (CT) images can be used to differentiate between paranasal sinus cysts (PSC) and progressive ethmoid haematomas (PEH), two conditions frequently observed in horses’ paranasal sinus system. The study concluded that CT images are highly effective in differentiating between the two conditions, with specific characteristics being more significant in either PSC or PEH.
Methodology
- The researchers utilized data from four European equine referral centres, focusing on horses that underwent a CT examination for PSC or PEH.
- The cases were reviewed retrospectively and were anonymised for evaluation.
- They also included cases with confirmed sinusitis to serve as control cases.
- Multiple observers evaluated the images to analyze their ability to differentiate between the three diseases.
- The study analysed several imaging characteristics for each disease.
- The final study involved 97 horses, with 24 diagnosed with PEH, 28 with PSC and 45 with sinusitis.
Findings
- There was a significant agreement between the CT diagnosis and the final diagnosis for all three observers, indicating the reliability of CT imaging for differentiation.
- They found heterogeneity and attenuation of the lesion to be higher in PEH cases.
- Specific features such as mineralisation within the soft tissue structure, distortion (both inner and outer) of bone and soft tissues were prevalent in PSC cases.
- Few cases showed dental distortion and a mineralised wall, which were significantly more common in PSC.
Limitations and conclusions
- The study only included cases that subsequently underwent treatment, highlighting that the majority of the cases were at an advanced stage.
- Not all cases had a histological examination available, which could limit the interpretation of some data.
- Despite these limitations, the study found that differentiation between PEH and PSC using CT images was excellent.
- Therefore, the different characteristics highlighted in the study might help veterinarians better distinguish between these two diseases.
Cite This Article
APA
Berner D, Hellige M, Harvey GG, Gerlach K, Iglesias-Garcia M, Manso-Diaz G.
(2025).
Differentiation of equine paranasal sinus cysts and progressive ethmoid haematomas on computed tomographic images.
J Equine Vet Sci, 150, 105609.
https://doi.org/10.1016/j.jevs.2025.105609 Publication
Researcher Affiliations
- Equine Referral Hospital, Department of Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, AL9 7AT, UK. Electronic address: dberner@rvc.ac.uk.
- Clinic for Horses, University of Veterinary Medicine Hannover, Buentweg 9, Hannover, 30559, Germany.
- Equine Referral Hospital, Department of Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield, AL9 7AT, UK.
- Clinic for Horses, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 21, Leipzig, 04103, Germany.
- Veterinary Teaching Hospital, University of Extremadura, Avenida de la Universidad, s/n. Cáceres, 10003, Spain; Equine Surgery, Veterinary Hospital. Veterinary Department. School of Biomedical and Health Sciences, Universidad Europea de Madrid, 28005 Villaviciosa de Odón, Spain.
- Department of Animal Medicine and Surgery, Universidad Complutense de Madrid, Avda. Puerta de Hierrro s/n, Madrid, 28040, Spain.
Conflict of Interest Statement
Declaration of competing interest None of the authors has any financial or personal relationships that could inappropriately influence or bias the content of the paper.
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