霉菌性鼻窦炎的CT、MRI诊断

CT and MRI diagnosis of fungal infection of paranasal sinuses

目的 探讨霉菌性鼻窦炎的CT、MRI表现和诊断价值。 方法 2 1例均行CT扫描并经手术病理证实 ,其中 5例行MRI检查 ,回顾性分析CT、MRI表现 ,探讨本病的诊断与鉴别诊断。 结果 (1) 2 1例一侧上颌窦均受累 ,10例同侧筛窦或鼻腔受累 ,11例窦壁骨质破坏 ,常见于上颌窦内侧壁 ;(2 )CT显示 19例 (90 % )上颌窦炎性病变中央见斑点样钙化 ,与窦壁无关 ,为霉菌性鼻窦炎的特征性表现 ;MRI显示病变中央为低信号 ,T2信号比T1信号更低 ,周围为明显长T2高信号。 结论 霉菌性鼻窦炎有较特征性的CT、MRI表现 ,CT是首选的影像检查方法 ,MRI评估病变窦腔外受累及与肿瘤鉴别优于CT。

Objective To evaluate CT and MRI manifestations and diagnostic value in fungal infection of paranasal sinuses. Methods CT scan was performed in all cases,additional MRI was carried out in 5 cases,all cases verified by surgery and pathology,their CT and MRI manifestations were retrospectively analyzed. Results The unilateral maxillary sinuses of all cases were involved,with the ipsilateral ethmoid sinuses invaded,localized bone destruction was seen in 11 cases.Speckled calcification was seen in the inflammatory exudation within the sinuses in 19 cases,which were displayed low-signal on T1WI and T 2W 1,peripheral High-inTense signa was present on T 2W 1. Conclusion Fungal infection of paranasal sinus displays characteristic signs on both CT and MRI,CT should be regarded as the exam of first choice for fungal infection of paranasal sinus.MRI is superior to CT on defining involved site out of sinus and differentation or suspected fungal infection or neoplasm.