霉菌性鼻窦炎的CT表现及其病理学基础

【目的】探讨霉菌性鼻窦炎CT表现及病理学特点，以提高对本病的认识和诊断水平。【方法】回顾性分析28例经手术病理证实的霉菌性鼻窦炎，其中病变累及单侧上颌窦者17例，累及一侧上颌窦及同侧筛窦者5例，累及一侧上颌窦及同侧筛窦、鼻腔者3例，累及双侧上颌窦者3例。【结果】霉菌性鼻窦炎CT表现主要为：病变窦腔内软组织影充填22例，病灶内斑点、条片样钙化26例，窦腔骨壁增厚20例，窦腔缩小16例，骨壁破坏5例。病理表现为被覆假复层纤毛柱状上皮黏膜组织中有较多炎性渗出物、坏死物及淋巴细胞和多形核细胞浸润，可见茵丝、孢子。【结论】病变内钙化影的出现是本病的主要CT表现，是诊断该病较为可靠的依据。

CT Findings and Pathological Foundation of Mycotic Sinusitis

Objective] To explore the CT findings and pathological features of mycotic sinusitis in order to improve the knowledge and the diagnosis of the disease. Methods] A total of 28 patients with mycotic sinusi- tis confirmed by the surgery were analyzed retrospectively. In all patients, 17 patients had the involvement of unilateral maxillary sinus, 5 patients had the involvement of unilateral maxillary sinus and ipsilateral ethmoid sinus, 3 patients had the involvement of unilateral maxillary sinus, ipsilateral ethrnoid sinus and nasal cavity, and 3 patients had the involvement of bilateral maxillary sinus. Results]The major CT findings of mycotic si- nusitis were soft tissue shadow filled in maxillary sinus（22 cases）, spotty, stripy and slabby calcifications in lesions（26 cases）, thickening of sinus bony wall（20cases）, narrowing of sinus cavity（16 cases） and sinus bony wall destruction（5 cases）. The pathological features were inflammatory exudation, necrosis, lymphocyte and polymorphonuelear cell infiltration together with hyphae and spores in coated pseudostratified ciliated columnar mucous membrane. Conclusion]The major CT findings of the disease is the appearance of calcified shadow in lesion, which is the reliable basis of the diagnosis.