Chen X L, Xian J F, Lu X X
Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Department of Laboratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2019 Nov 19;99(43):3417-3419. doi: 10.3760/cma.j.issn.0376-2491.2019.43.013.
To evaluate the value of CT in the differential diagnosis of sinusitis and fungal ball in paranasal sinus caused by . In this retrospective study, CT results of 74 cases of sinusitis including 31 male cases and 43 female cases with age onset from 15 to 74 years old (mean±SD was 50±13) and 72 cases of fungal ball in paranasal sinus caused by including 28 male cases and 44 female cases with age onset from 25 to 78 years old (mean±SD was 53±15) at Beijing Tongren Hospital confirmed by histopathology were enrolled from January 2013 to May 2017. The CT characteristics of the two groups of cases were compared using χ(2) test, and 0.05 was considered statistically significant. Soft tissue opacification of the involved paranasal sinus was found on CT in each case of the two groups. There were significant differences in the rate of single sinus involvement (44.6% and 90.3% respectively), the incidence of lesion associated with maxillary sinus (91.9% and 70.8% respectively), ethmoid sinus (41.9% and 2.8% respectively), frontal sinus (29.7% and 0 respectively), calcification (50.0% and 72.2% respectively), and the enlargement of maxillary sinus opening (13.2% and 35.3% respectively), in addition to the central calcification (83.8% and 59.6% respectively) between the two groups (all 0.05). However, the incidence of sphenoid sinus involvement (32.4% and 34.7% respectively), bone sclerosis (56.8% and 62.5% respectively) or destruction(18.9% and 16.7% respectively) were not found different between the two groups (0.05). Though the CT findings are similar between the two diseases such as soft tissue opacification of the involved paranasal sinus with calcification and bone sclerosis or destruction, there are still a few characteristics on CT in differentiating the one from the other. The involvement of multi-sinuses, maxillary sinus, ethmoid sinus and frontal sinus, the central calcification are more common in the sinusitis. However, the CT features including single sinus involvement, calcification and enlargement of maxillary sinus opening, can be seen more often in the fungal ball in paranasal sinus caused by .
评估CT在诊断鼻窦炎与鼻窦真菌球中的鉴别诊断价值。在这项回顾性研究中，纳入了2013年1月至2017年5月在北京同仁医院确诊的74例鼻窦炎患者（其中男性31例，女性43例，年龄15至74岁，平均±标准差为50±13岁）以及72例鼻窦真菌球患者（其中男性28例，女性44例，年龄25至78岁，平均±标准差为53±15岁），所有病例均经组织病理学证实。采用χ(2)检验比较两组病例的CT特征，以P<0.05为差异有统计学意义。两组病例的CT均显示受累鼻窦软组织密度增高。两组在单鼻窦受累率（分别为44.6%和90.3%）、与上颌窦相关病变的发生率（分别为91.9%和70.8%）、筛窦（分别为41.9%和2.8%）、额窦（分别为29.7%和0）、钙化（分别为50.0%和72.2%）以及上颌窦开口扩大（分别为13.2%和35.3%），此外还有中央钙化（分别为83.8%和59.6%）方面存在显著差异（均P<0.05）。然而，两组在蝶窦受累率（分别为32.4%和34.7%）、骨质硬化（分别为56.8%和62.5%）或骨质破坏（分别为18.9%和16.7%）方面差异无统计学意义（P>0.05）。虽然两种疾病的CT表现有相似之处，如受累鼻窦软组织密度增高伴钙化及骨质硬化或破坏，但CT在两者鉴别上仍有一些特征。多鼻窦受累、上颌窦、筛窦和额窦受累以及中央钙化在鼻窦炎中更常见。然而，单鼻窦受累、钙化以及上颌窦开口扩大等CT特征在鼻窦真菌球中更常见。
