Li Yongqi, Li Yuan, Zhang Gehua, Liu Xian, Ye Jin
Department of Otorhinolaryngology-Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China.
Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2004 May;18(5):282-4.
To discuss the computer tomography (CT) characteristics of chronic invasive fungal rhinosinusitis in early stage and their diagnostic value.
The CT characteristics of 18 cases of chronic invasive fungal rhinosinusitis in early stage and 35 noninvasive fungal rhinosinusitis diagnosed with pathologic examination were retrospectively analyzed and compared.
On sinus CT scan of chronic invasive fungal rhinosinusitis in early stage, 78% (14/18) were single-sinus lesioned. The maxillary sinus was the most commonly lesioned sinus, followed by the sphenoid sinus and ethmoid sinus. 22% (4/18) were poly-sinus lesioned. All infected sinus showed complete or subtotal heterogeneous opacity. In 62% (12/18) cases the lesion expanded into the adjacent sinus or nasal cavity. 78%(14/18)had calcification spots or points (CT number between 80 Hu and 160 Hu) in the soft tissue window. Bony destruction occurred in 6 cases (33%), in which lamina papyracea and middle turbinates were mostly destructed simultaneously each in 2 cases. Chronic invasive fungal rhinosinusitis had more poly-sinus lesioned cases and bony destructed cases than noninvasive fungal rhinosinusitis and its bone lesion degree was higher too.
Chronic invasive fungal rhinosinusitis in early stage has more poly-sinus lesioned cases and higher bony destruction ratio and degree. But its total CT characteristics are similar with noninvasive fungal rhinosinusitis. So sinus CT scan has no specific meaning in diagnosing of chronic invasive rhinosinusitis in early stage.
探讨早期慢性侵袭性真菌性鼻窦炎的计算机断层扫描(CT)特征及其诊断价值。
回顾性分析并比较18例经病理检查确诊的早期慢性侵袭性真菌性鼻窦炎患者和35例非侵袭性真菌性鼻窦炎患者的CT特征。
早期慢性侵袭性真菌性鼻窦炎鼻窦CT扫描显示,78%(14/18)为单鼻窦病变,其中上颌窦最常受累,其次为蝶窦和筛窦;22%(4/18)为多鼻窦病变。所有受累鼻窦均表现为完全或部分不均匀密度增高影。62%(12/18)的病例病变扩展至相邻鼻窦或鼻腔。78%(14/18)在软组织窗可见钙化斑或钙化点(CT值在80 Hu至160 Hu之间)。6例(33%)出现骨质破坏,其中纸样板和中鼻甲各有2例同时受累最为常见。与非侵袭性真菌性鼻窦炎相比,慢性侵袭性真菌性鼻窦炎多鼻窦病变及骨质破坏病例更多,骨质破坏程度也更高。
早期慢性侵袭性真菌性鼻窦炎多鼻窦病变及骨质破坏比例和程度更高,但其总体CT特征与非侵袭性真菌性鼻窦炎相似,因此鼻窦CT扫描对早期慢性侵袭性鼻窦炎的诊断无特异性意义。