182例真菌球型鼻窦炎临床及CT特征分析

Analysis of CT imaging and clinical characteristics of 182 cases of fungal ball sinusitis

目的探讨真菌球型鼻窦炎(fungal ball sinusitis,FBS)的流行病学特点、症状及CT影像学特征。方法回顾182例经病理确诊FBS患者的临床资料,针对其人群学特点、累及鼻窦范围及影像表现进行分析。结果FBS患者中单侧上颌窦受累为主占79.1%(144/182),头面部疼痛为其最常见临床症状,占45.6%(83/182);CT影像学方面钙化斑及骨质增生两种影像学特征总发生率为93.4%(170/182);真菌球感染对于不同鼻窦间产生骨质增生的情况无统计学差异(P>0.05);真菌球型上颌窦炎及真菌球型蝶窦炎累及鼻中隔的概率相同(P>0.05),CT影像学中存在高密度影与否不会增加病理学检出曲霉菌的概率(P>0.05)。结论不同鼻窦感染真菌球,其窦壁出现骨质增生及鼻中隔骨质受累的概率相同。

OBJECTIVE To explore the epidemiological characteristics,symptoms and CT features of fungal ball sinusitis.METHODS A retrospective analysis was conducted on the clinical data of 182 patients with pathologically confirmed fungal ball sinusitis,in which demographic characteristics,sinus involvement,and imaging manifestations were analyzed.RESULTS Unilateral maxillary sinus involvement was predominant(144 cases,79.1%).Head and facial pain(83 cases,45.6%)was the most common clinical symptom.In terms of CT imaging,the total incidence rate of calcification and bone hyperplasia is 93.4%(170/182);There was no statistically significant difference in the occurrence of bone hyperplasia between different sinuses caused by fungal infections(P>0.05).The probability of fungal maxillary sinusitis and fungal sphenoid sinusitis affecting the nasal septum is the same(P>0.05).The presence or absence of high-density shadows in CT imaging does not increase the probability of pathological detection of Aspergillus(P>0.05).CONCLUSION The probability of bone hyperplasia and accumulation of nasal septum bone in different sinuses infected with fungal balls is the same.