[Non-distinctive features on CT scan of fungal sinusitis]

This article was a retrospective analysis on the preoperative CT scan of fungal sinusitis patients. The non-distinctive clinic feature was suggested to improve the accuracy of preoperative diagnosis.

A retrospective analysis was made for 176 patients with fungal sinusitis,which were confirmed by postoperative pathologic diagnosis from January 2000 to January 2008. Every patient was performed both CT examination and nasal endoscopy preoperatively. All patients underwent endoscopic sinus surgery and the lesions in sinus were cleared and confirmed fungal infection by pathology. Thirty-five cases fungal infection located in sphenoid sinus, 84 cases in maxillary sinus, 49 cases in both maxillary and ethmoid sinus, 3 cases in all sinus, 5 cases in both ethmoid and sphenoid sinus. There were 179 sinuses in 176 patients were infected.

This group totally had 175 cases (179 sides). One hundred and seventy-three cases had unilateral lesion,3 cases had bilateral lesion. The CT scan showed non-distinctive features including uniform dense, uneven dense in the sinus and bone resorption of the inner side bone wall. Five cases in sphenoid sinus lesion were found calcification in CT scan but 8 cases didn't show such features. Among these cases, 5 cases showed uniform dense and 3 cases showed uneven dense. In 84 cases maxillary sinus lesion, there were 12 cases without distinctive change, among these cases,8 cases showed uniform dense, 4 cases showed uneven dense and 5 cases had bone resorption. In 49 cases both ethmoid and maxillary sinus lesion, 13 cases didn't show distinctive change, among these cases, 9 cases showed uniform dense, 4 cases showed uneven dense and 6 cases had bone resorption. Five cases had calcification in the both sphenoid and ethmoid sinus. Totally 81.56% of these patients had calcification feature in the CT scan.

The calcification in the lesion of sinus is usually featured as characteristic manifestation of fungal sinusitis. But in clinic, the calcification does not exit in some patients CT scan. When being absent of the featured sign in CT scan, the fungal sinusitis have to be diagnosed by other detecting means,even postoperative pathology.