真菌球型鼻窦炎的临床及影像学特征

Clinical and imaging characteristics of fungus ball rhinosinusitis

目的回顾性分析35例真菌球型鼻窦炎患者的临床及影像学特征。方法本文收集2010年4月~2013年7月35例在西京医院耳鼻咽喉头颈外科行经鼻内镜鼻腔鼻窦手术,术后病理确诊为真菌球型鼻窦炎患者的临床及影像学资料。总结及分析临床表现(年龄、性别、主要症状等),以及术前CT、MRI影像特征。结果 35例真菌球型鼻窦炎患者均累及单侧;患者年龄分布23~80岁,平均年龄为50.2岁,其中女19例,略占优势(54.3%);71.4%患者居住于城市(21/35);临床最常见的症状主要表现为鼻塞和脓涕;11%患者过敏原检测结果呈阳性(2/19),31.4%患者同时伴有息肉(11/35);8.6%患者有糖尿病病史(3/35);组织学分型提示最常见的病原体为曲霉菌(6/35);48.6%患者CT检查局部密度增高且不均匀,有星状分布钙化点(17/35);16例患者的T2加权MRI扫描中有局灶性低密度区表现者占100%(16/16)。结论老年、女性更易患真菌球型鼻窦炎;CT扫描未能确诊的病例,有必要进行MRI扫描。

OBJECTIVE To study the clinical and imaging characteristics of fungus ball rhinosinusitis.METHODS The clinical and imaging data of 35 cases of fungus ball rhinosinusitis treated with endoscopic nasal surgery from April,2010 to July,2013 were retrospectively analyzed.The features of preoperative CT and MRI,age,gender,chief complaint,causative fungus,and clinical outcome were analyzed.RESULTS Patients were aged from 23 to 80 years(mean 50.2 years).Female predominance was noted(54.3%).Most common symptoms were nasal obstruction and purulent nasal discharge.CT showed high density area in 48.6% of the cases(17/35),whereas T2-weighted MR imaging showed low intensity area in cases.CONCLUSION The aged female predominance is consistent with previous repor ts.MR imaging is recommended to confirm the diagnosis.