真菌性鼻-鼻窦炎的CT影像特征

目的 探讨真菌性鼻-鼻窦炎的CT表现及其诊断价值。方法 回顾性分析2007年1月至2013年12月收治的47例经手术病理证实的真菌性鼻-鼻窦炎患者的CT影像资料。结果 单侧病变43例，双侧4例，以上颌窦最多见。病变窦腔CT检查均见软组织密度影充填。密度不均匀37例(78.7%)，可见点状、条形或团块状钙化灶，CT 值100～150 HU；密度均匀软组织影10例(22.2%)；窦腔骨质增厚39例(83.0%)；窦腔缩小20例(42.6%)；内含气泡影11例(23.4%)。41例上颌窦受累患者中窦口阻塞并扩大33例(80.5%)；上颌窦内侧骨壁破坏吸收15例(36.6%)。结论 真菌性鼻-鼻窦炎的CT特征性表现为病变窦腔密度不均匀增高，内有局灶性点状、絮状、砂粒状、小斑片状高密度影，可有窦壁骨质破坏。CT对真菌性鼻-鼻窦炎的诊断和治疗有较高的临床价值。

Characteristics of computed tomography of fungal rhino-sinusitis

Objective To study the CT features of fungal rhino-sinusitis and to assess its diagnostic value. Methods CT features of 47 cases of fungal rhino-sinusitis proved by surgery and pathology from January 2007 to December 2013 were retrospectively analyzed. Results There are 43 cases of unilateral fungal infection and 4 cases of double sides. On CT scanning, soft tissues were presented in all the infected sinuses of all cases, heterogeneous density with spot,strip or lump calcification was presented in 37 cases(78.7%) and homogeneous density was presented in 10 cases(22.2%). There were bones thickening in 39 lesions(83.0%), dwindling of sinus in 20 patients(42.6%), and air bubble in 11 cases(23.4%).In 41 cases that lesions implicated in the maxilla, 33 cases(80.5%) showed obstruction and dilation of maxillary sinus ostium and 15 cases(36.6%)showed damage or resorption of medial wall. Conclusion Fungal rhino-sinusitis has characteristic findings on CT. The major CT findings are heterogeneous density of sinusal cavity with small calcification appeared as spots,floccose,sand-like or patchy shadows and local bone destruction. CT is a valuable method for diagnosis and treatment of fungal rhino-sinusitis.