真菌性副鼻窦炎的临床与CT诊断

目的：分析真菌性副鼻窦炎的临床与CT征象。探讨CT在真菌性副鼻窦炎临床诊断中的价值。方法：对12例经手术治疗后病理证实的真菌性副鼻窦炎进行回顾性分析。结果：全组病例以回缩性滋血或脓血滋为主要症状。CT显示病的鼻窦腔内不均匀的密度增高影，其中7例在上凳窦腔内可见斑块，斑点状钙化影；5例伴有上凳窦壁骨质增生硬化；2例伴有上凳窦内侧壁骨质吸收变薄。手术发现累及的鼻窦腔内有大量的污秽坏死 织或充满炎性息肉状物。病理检验示坏死组织中有成团的真菌菌丝。结论真菌性副鼻窦炎的诊断主要根据临床症状及影像学检查，确诊有赖于病理。CT在显示副鼻窦解剖结构和诊断真菌性副鼻窦炎方面具有重要参考价值。

Fungous Sinusitis and CT of Diagnosis

Objective To analyze the clinical symptoms and CT findings of fungus sinusitis in order to evaluate CT diagnosis. To analyze retrospectively the collected data of 12 patients who underwent operations for fungos sinusitis which was proved pathologically. The main clinical feature of fungos sinusitis was bloody supperative rhinorrhea in all cases. In the CT scans, we found the density of the involved sinus cavities rised inhomogeneities in all patients. CT scans also showed spot-like calcification in 7 cases, bony proliferation in 5 cases and bony absorption in 2 cases. The operation revealed a lot of filthy or inflammatory polypoid substances in the involved sinus cavities in all patients. Pathological examination demonstrated clusters of fungus in the filthy substances. The diagnosis of fungus sinusitis mainly derived from clinical symptoms and radiological examinations. The final diagnosis depended on pathology. It is of great value for reference that CT scans can show the anatomical structures of the sinuses and help to diagnose fungus sinusitis.