Roithmann R, Shankar L, Hawke M, Chapnik J, Kassel E, Noyek A
Department of Otolaryngology, Mount Sinai Hospital, University of Toronto, Canada.
Rhinology. 1995 Jun;33(2):104-10.
Fungal sinusitis should always be considered in the differential diagnosis of chronic or recurring sinusitis resistant to adequate medical treatment. A high index of suspicion is necessary for the diagnosis, and the clinical examination is rarely conclusive. The definitive diagnosis depends on the pathologist in most cases. We reviewed retrospectively the imaging findings, specifically computed tomography (CT) and magnetic resonance (MR), in a series of fungal sinusitis patients. Non-enhanced CT scan is more sensitive than conventional X-ray in detecting the classical focal areas of hyper-attenuation and calcification seen in soft-tissue masses of fungal sinusitis. MR findings of hypo-intense signals on T1-weighted sequences which progress to signal-void area on T2-weighted sequences, are characteristic features of fungal sinusitis; however, it is reserved for cases where intracranial invasion is suspected or CT findings are inconclusive.
在对经充分药物治疗仍有抵抗的慢性或复发性鼻窦炎进行鉴别诊断时，应始终考虑真菌性鼻窦炎。诊断需要高度的怀疑指数，而临床检查很少能得出结论。在大多数情况下，明确诊断依赖于病理学家。我们回顾性分析了一系列真菌性鼻窦炎患者的影像学表现，特别是计算机断层扫描（CT）和磁共振成像（MR）。在检测真菌性鼻窦炎软组织肿块中典型的高密度和钙化灶方面，非增强CT扫描比传统X线更敏感。T1加权序列上低信号、T2加权序列上进展为信号缺失区的MR表现是真菌性鼻窦炎的特征性表现；然而，它仅用于怀疑有颅内侵犯或CT表现不明确的病例。
