霉菌性上颌窦炎CT表现特征及误诊分析

目的探讨霉菌性上颌窦炎CT特征及误诊原因。方法分析26例霉菌性上颌窦炎患者CT和临床资料,总结CT特征,结合临床,分析误诊原因。结果霉菌性上颌窦炎CT多单侧受累（23例）。受累窦腔内不均匀密度增高影及其内斑点、团块及条状钙化（21例）,分布在中间15例,散在4例,边缘2例。窦壁增厚7例,窦壁骨质吸收4例。5例均误诊为一般上颌窦炎。结论与窦壁无关的腔内钙化是CT诊断较可靠特征。无钙化的霉菌性上颌窦炎应注意鉴别诊断,充分考虑临床和基础病。

CT findings of mycotic maxillary sinusitis and the cause of misdiagnosis

Objective To study CT findings of mycotic maxillary sinusitis（MMS） and the cause of misdiagnosis. Methods The clinical and CT findings of 26 patients with surgically and pathologically proved MMS were analyzed retrospectively,and to explore the cause of misdiagnosis.Results The CT findings of 23 patients with MMS were unilateral lesion.The CT findings of 21 patients were non-homogeneous soft tissue shadows filled into maxillary sinus and associated with granular,circular and massive calcification.In the middle of the distribution of 15 cases,in disorder 4 cases,2 cases at edge.Seven cases showed local proliferation and 4 cases showed local bone destruction.There were 5 cases who were misdiagnosed with common maxillary sinusitis.Conclusion The mainly CT feature of non-invasive fungal sinusitis is having calcification inside the lesions,that is the basis of diagnosis.Calcification is the pivotal CT signs on diagnosing mycotic nasosinusitis.Differential diagnosis should be thought highly if there are no calcification.