如何诊断鼻窦真菌球？对 1999 年 1 月至 2006 年 12 月某机构病例的分析。
How to diagnose sinus fungus balls in the paranasal sinus? An analysis of an institution's cases from January 1999 to December 2006.
机构信息
Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Zurich, Zürich, Switzerland.
出版信息
Rhinology. 2009 Dec;47(4):379-84. doi: 10.4193/Rhin09.026.
BACKGROUND
The diagnosis of a sinus fungus ball (SFB) is often not clear despite well-defined diagnostic criteria.
OBJECTIVE
To study the radiological, intraoperative and histological diagnostic accuracy in comparison to results from mycological and histological analysis.
METHODS
Systematic review of 724 files from patients treated for chronic rhinosinusitis from 1999 - 2006 at our institution.
RESULTS
The sensitivity, specificity, positive and negative predictive value (PPV, NPV) of pre- operative CT imaging was 83%, 94%, 56% and 98% respectively, whereas, based on intra- operative findings, it was 98%, 93%, 57% and 100%.
CONCLUSIONS
A high number of misdiagnoses was found possibly due to sampling error. A severe inflammatory reaction of the surrounding tissue was found more often in SFB than in controls in our study and this we suggest could be an additional sign for fungal infection. Fungal cultures did not contribute to a correct diagnosis.
背景
尽管有明确的诊断标准，但鼻窦真菌球（SFB）的诊断仍不明确。
目的
研究放射学、术中及组织学诊断的准确性，并与真菌学和组织学分析的结果进行比较。
方法
对我院 1999 年至 2006 年治疗慢性鼻-鼻窦炎的 724 例患者的资料进行系统回顾。
结果
术前 CT 成像的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）分别为 83%、94%、56%和 98%，而根据术中发现，敏感性、特异性、阳性预测值、阴性预测值分别为 98%、93%、57%和 100%。
结论
本研究中，可能由于取样误差导致大量误诊。与对照组相比，SFB 周围组织的炎症反应更为严重，我们认为这可能是真菌感染的另一个附加征象。真菌培养对正确诊断没有帮助。
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