CT检查对变应性真菌性鼻窦炎术前诊断的价值

The value of CT scan in preoperative diagnosis of allergic fungal rhinosinusitis

目的探讨变应性真菌性鼻窦炎的CT表现及术前诊断价值,增进对该病的影像学认识,提高鼻窦内窥镜手术的疗效,降低并发症。方法行鼻内镜手术治疗并经组织病理学检查证实为变应性真菌性鼻窦炎的33例患者,对其临床资料及影像学资料进行总结,并以组织病理学结果作为标准分析评价CT检查对变应性真菌性鼻窦炎的术前诊断价值。结果变应性真菌性鼻窦炎累及全组鼻窦者28例,累及半组鼻窦者5例;CT扫描33例表现为窦腔内充满软组织影,有的伴有多发条状、斑片状高密度影,边界清楚,有的伴有云雾状高密度影,边界模糊;受累鼻窦膨胀27例,窦壁骨质变薄26例,窦壁骨质侵蚀5例,5例病变延伸到临近结构。结论 CT是诊断变应性真菌性鼻窦炎的重要影像学手段,能清楚地显示病灶以及受累的程度、范围,为临床分期、制定治疗方案提供依据。

Objective To study the CT scan features and preoperative diagnosis value of allergic fungal rhinosinusitis, to enhance imaging cognition of allergic fungal rhinosinusitis, and to improve the curative effect of endoscopic sinus surgery and decrease complications. Methods Clinical and imaging date of 33 patients with allergic fungal, who received endoscopic sinus surgery and confirmed by histopathological examination were summarized. Histopathological results were used as standards for analysis of the preoperative diagnosis value of CT scan in allergic fungal rhinosinusitis. Results Among the 33 cases of allergic fungal rhinosinusitis, there were 28 cases with all involved sinuses, and 5 cases with half involved sinuses. CT scan showed that 33 cases all had soft tissue shadow filling in sinus cavity, and some cases had multiple patch and strip high density shadow with clear border, while other cases had cloud high density shadow with vague border. There were 27 cases with involved sinuses expansion, 26 cases with sinuses wall sclerotin attenuation, 5 cases with sinuses wall sclerotin erosion, and 5 cases with extended lesion on close structure. Conclusion CT scan plays an important role in the diagnosis of allergic fungal rhinosinusitis. CT scan can show the nidus and involved range and degree, it also can provide information for clinical stages and treatment plan.