[Computer tomography characteristics of chronic invasive fungal rhinosinusitis in early stage]

Abstract

Objective: To discuss the computer tomography (CT) characteristics of chronic invasive fungal rhinosinusitis in early stage and their diagnostic value.

Method: The CT characteristics of 18 cases of chronic invasive fungal rhinosinusitis in early stage and 35 noninvasive fungal rhinosinusitis diagnosed with pathologic examination were retrospectively analyzed and compared.

Result: On sinus CT scan of chronic invasive fungal rhinosinusitis in early stage, 78% (14/18) were single-sinus lesioned. The maxillary sinus was the most commonly lesioned sinus, followed by the sphenoid sinus and ethmoid sinus. 22% (4/18) were poly-sinus lesioned. All infected sinus showed complete or subtotal heterogeneous opacity. In 62% (12/18) cases the lesion expanded into the adjacent sinus or nasal cavity. 78%(14/18)had calcification spots or points (CT number between 80 Hu and 160 Hu) in the soft tissue window. Bony destruction occurred in 6 cases (33%), in which lamina papyracea and middle turbinates were mostly destructed simultaneously each in 2 cases. Chronic invasive fungal rhinosinusitis had more poly-sinus lesioned cases and bony destructed cases than noninvasive fungal rhinosinusitis and its bone lesion degree was higher too.

Conclusion: Chronic invasive fungal rhinosinusitis in early stage has more poly-sinus lesioned cases and higher bony destruction ratio and degree. But its total CT characteristics are similar with noninvasive fungal rhinosinusitis. So sinus CT scan has no specific meaning in diagnosing of chronic invasive rhinosinusitis in early stage.