鼻窦真菌病的CT诊断

CT Diagnosis of Fungal Disease in the Paranasal Sinuses

目的 :探讨鼻窦真菌病的CT表现特征。材料和方法 :回顾分析103例手术和病理证实的鼻窦真菌病的CT表现 ,其中累及上颌窦及蝶窦分别为93和10例。结果 :病变未充满窦腔56例(54.4 %) ,充满窦腔47例(45.6 %)。密度不均匀87例(84.4) ,均匀16例(15.6 %)。全窦腔受累者 ,其病变中心密度高于外周密度 ;病变涉及部分窦腔者显示为中央不规则的高密度软组织团块影伴窦壁黏膜增厚。93例上颌窦真菌中 ,41例有高密度软组织团块突向中鼻道伴骨性窦口扩大和骨质侵蚀。所有受犯鼻窦均伴有窦壁骨质增厚和硬化。91.3 %的病例在高密度软组织病变内还可见钙化。所有行增强后扫描者均未见强化表现。结论 :鼻窦真菌病具有特征性的CT表现 ,CT平扫应作为本病首选检查方法。

Purpose:To study the CT characteristics of sinonasal fungal disease.Materials and Methods:103 cases of sinonasal fungal diseases proved by operation and pathology were analyzed retrospectively.Maxillary and sphenoid sinuses were involved in 93 and 10 cases respectively.Results:The fungus involved sinuses were partially opaque in 56 cases(54.4%)and completely opaque in 47 cases(45.6%).The density of opacity was inhomogeneous in 87 cases(84.4%)and homogeneous in 16 cases(15.6%).In cases with whole sinus involvement,the density of the central part of the lesion was usually higher than that of the peripheral one.In all cases with partially opaque sinus the fungal disease presented as an irregular high density soft tissue mass inside the air-filled sinus with mucosal thickening. In 41 of 93 cases with ma xillary involvement,the high density soft tissue mass protruded into the middle meatus with enlargement and erosion of bony maxillary ostium.All cases had bone thickening and sclerosis of the wall of sinus,and 91.3% cases had calcification in the high density soft tissue lesion.No enhancement could be seen in all cases with post-contrast CT images.Conclusion:The CT findings of sinonasal fungal disease is characteristic.Plain CT examination should be used as a method of first choice in the diagnosis of the disease.