CT诊断真菌性鼻窦炎100例分析

Analysis of CT diagnose for fungal sinusitis in 100 cases

目的回顾性总结真菌性鼻窦炎CT影像表现,并结合临床,探讨CT检查对诊断真菌性鼻窦炎的临床价值。方法收集100例确诊为真菌性鼻窦炎的病人资料并结合临床检查结果,与CT检查进行分析比较。鼻窦CT扫描采用骨窗和软组织窗扫描。结果 100例患者均为单侧鼻窦发病,其中真菌球型68例,慢性侵袭性真菌性鼻窦炎4例,变应性真菌性鼻窦炎28例。CT扫描影像特点为鼻窦腔散在较均匀毛玻璃特征或极不规则的线状,有星状分布的钙化点;伴不同程度骨质吸收或结构不清;窦壁骨质侵蚀15例。病变延伸到邻近结构3例,其中1例累及眼眶。有2例侧颅底骨质吸收。鼻腔或鼻窦内分布黏蛋白与CT显示毛玻璃样高密度影一致。结论真菌性鼻窦炎的鼻窦CT扫描显示与其他鼻窦炎不同。CT检查有助于准确诊断真菌性鼻窦炎。

Objective To summarize the fungal sinusitis of fungal sinusitis retrospectively and to analyze the clinical value of CT diagnose for fungal sinusitis. Methods The data of 100 patients with fungal sinusitis and the clinical examination results were compared with CT diagnose.Bone window and soft-tissue window scans were performed for sinus CT scans. Results 100 cases suffered unilateral nasal sinusitis disease.There were 34 cases of fungus ball,4 cases of chronic invasive fungal sinusitis,and 28 cases of allergic fungal sinusitis.The characteristics of imaging showed that there were well-distributed high density frosted glass shadow,or extremely irregular linar,there are decentralization calcification spots distribute in the sinuses.And accompany different degree bone resorption or the structures were unclearly.There were 15 cases of sinus wall bone erosion,lesions extended to adjacent structures in 3 cases,extended to eye socket in 1 case and 2 cases with bone absorption of lateral skull base.The mucin in nasal or sinus were in accord with the high density of ground-glass opacity which showed by CT scan. Conclusion The imaging of CT of these patients＇ representations were different with others paranasal sinusitis.It can aid accurate diagnose the fungal sinusitis.