Radiologic–Histopathologic Correlation in Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis

Background: Chronic rhinosinusitis (CRS) is a heterogeneous inflammatory condition of the sinonasal mucosa. Radiological imaging, particularly computed tomography (CT), is widely used to assess disease severity, while histopathology remains the gold standard for evaluating mucosal inflammation.

Objective: To systematically evaluate and quantify the correlation between radiological findings and histopathological changes in CRS.

Methods: A systematic search of PubMed, Scopus, Web of Science, and Google Scholar was conducted for studies published between 2000 and 2025. Studies reporting both radiological findings and histopathological evaluation were included. A random-effects meta-analysis was performed.

Results: Eighteen studies involving 1,964 patients were included. A moderate positive correlation was observed between radiological severity and histopathological inflammation (pooled r = 0.46; 95% CI: 0.32–0.58). Stronger correlation was noted in CRS with nasal polyps.

Conclusion: Radiological findings show moderate correlation with histopathological severity in CRS. Imaging should complement, not replace, histopathological evaluation.