真菌性鼻窦炎患者CT与MRI诊断分析

目的分析CT与MRI诊断真菌性鼻窦炎的临床价值。方法回顾性分析2011年6月-2015年5月于我院经病理证实为真菌性鼻窦炎的32例患者的临床资料,所有患者入院后均接受CT与MRI检查,总结其影像学特点,分析CT、MRI对真菌性鼻窦炎的诊断价值。结果 CT:32例中,上颌窦发病16例,右侧9例,左侧7例;9例蝶窦受累,筛窦7例。表现为窦腔内密度不均软组织影,软组织窗显示非规则窦腔内钙化,受累窦壁骨质可见增生硬化,窦周边界清晰;MRI:与脑实质比较,7例T1WI序列呈均匀低信号,21例等信号,4例伴少量低信号;T2WI病变以低信号为主,伴形态、数量不一高信号;受累鼻窦阻塞性炎症T2WI序列呈高信号,T1WI序列呈等信号,边缘伴明显强化。可侵犯眼眶、海绵窦、脑实质、侵犯颞下窝、翼腭窝,部分可见鼻咽部软组织增厚,可伴硬腭骨质破坏。结论在真菌性鼻窦炎诊断中,CT对钙化灶显示率高,可作为首选检查方法,而MRI在显示病变窦腔受累方面优势更佳。

Fungal Sinusitis in Patients with CT and MRI Diagnostic Analysis

Objective To analyze clinical value of CT and MRI in the diagnosis of fungal sinusitis. Methods A retrospective analysis from June 6, 2011-May 2015 in our hospital conducted by pathology for the clinical data of 32 cases with fungal sinusitis. All patients were examined by CT and MRI after admission. The authors summarized their imaging characteristics and analyzed the CT and MRI in the diagnosis of fungal sinusitis. Results CT: 32 cases of maxillary sinus disease in 16 cases, 9 cases on the right side, 7 cases on the left side, 9 cases of sphenoid sinus involvement, and 7 cases of ethmoid sinus. Uneven density of soft tissue were visible in the sinus cavity, soft tissue window showed irregular calcifications in sinus cavity, the affected sinus wall displayed bone hyperplasia and sclerosis, the paranasal sinus boundary was clear. MRI:Compared with brain parenchymal, 7 cases of T1WI showed low signal intensity, 21 cases showed equal signals, while 4 cases showed small amount of low signals. Lesions with the priority of low signals, together with few high signals of different forms and amount on T2WI, the affected sinus had obstructive inflammation that showed high signal on T2WI , while the T1WI sequence had equal signals with the obvious peripheral enhancement. Lesions could be invasive to orbit, cavernous sinus, brain parenchyma, infratetemporal fossa and pterygopalatine fossa, and the nasopharyngeal soft tissue had been thickened obviously together with the destruction of hard palate. Conclusion In the diagnosis of fungal sinusitis, the successful rate from CT for calcifications checking is higher. It can be used as the preferred examination method, and the advantage of magnetic resonance imaging (MRI) in the sinus cavity involvement is even better.