Gupta Kamini, Saggar Kavita
Department of Radiodiagnosis, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Ann Afr Med. 2014 Jul-Sep;13(3):119-23. doi: 10.4103/1596-3519.134398.
The purpose of this study was to analyze the computed tomography (CT) features of fungal sinusitis and to correlate them with nasal endoscopy and histopathological findings.
Our study included 16 patients of either sex and any age group who presented in the otorhinolaryngology clinic at our hospital and had evidence of definite sinonasal disease on clinical evaluation. Multidetector CT was carried out on Somatom definition AS + 128 slice CT Machine by Siemens Germany Ltd. Axial sections were performed with the plane of data acquisition parallel to the hard palate and slice thickness of 3 mm, reconstructions at 0.75 mm in coronal and sagittal planes. Scanning parameters included 190 mA S, 120 KV and tube rotation time of 0.5 s. Provisional CT diagnosis was made in all cases and correlated with nasal endoscopy and histopathological findings.
Out of total 16 patients, 12 showed immunocompromised status and had infection with mucormycosis. Out of 12, 9 patients (75%) showed extension of disease beyond the sinonasal cavities and 4 (33.3%) showed evidence of bone destruction. All patients with candidiasis showed soft-tissue attenuation with hyperdense areas on CT scan. Nearly, 66.6% patients with aspergillosis showed soft-tissue attenuation with hyperdense areas and expansion of sinonasal cavities. Fifteen patients (93%) were proved to be of fungal sinusitis on histopathology. One patient of non-specific granulomatous infection showed bone destruction and mimicked fungal sinusitis on CT.
In the present study, fungal sinusitis could be correctly diagnosed on CT with high accuracy. Thus, understanding the different CT findings of fungal sinusitis allows the radiologist to play a crucial role in the diagnosis and prompt treatment.
本研究旨在分析真菌性鼻窦炎的计算机断层扫描（CT）特征，并将其与鼻内镜检查及组织病理学结果相关联。
我们的研究纳入了16例患者，不限性别和年龄组，均在我院耳鼻喉科门诊就诊，且临床评估有明确鼻窦疾病证据。使用德国西门子公司的Somatom definition AS + 128层CT机进行多排CT检查。轴向扫描时数据采集平面与硬腭平行，层厚3 mm，在冠状面和矢状面以0.75 mm进行重建。扫描参数包括190 mA S、120 kV及管旋转时间0.5 s。所有病例均做出初步CT诊断，并与鼻内镜检查及组织病理学结果相关联。
16例患者中，12例显示免疫功能低下且感染毛霉菌病。在这12例中，9例（75%）疾病超出鼻窦腔，4例（33.3%）有骨质破坏证据。所有念珠菌病患者在CT扫描上显示软组织密度减低伴高密度区。近66.6%的曲霉菌病患者显示软组织密度减低伴高密度区及鼻窦腔扩大。15例（93%）经组织病理学证实为真菌性鼻窦炎。1例非特异性肉芽肿感染患者显示骨质破坏，CT表现类似真菌性鼻窦炎。
在本研究中，CT可高精度正确诊断真菌性鼻窦炎。因此，了解真菌性鼻窦炎的不同CT表现使放射科医生在诊断和及时治疗中发挥关键作用。
