Imaging approach for fungal sinusitis

Purpose of review: This article provides a comprehensive review of the computed tomography (CT) and magnetic resonance (MR) imaging findings of invasive fungal sinusitis with an emphasis on pattern recognition and approach to interpretation.

Recent findings: Fungal sinusitis is categorized into invasive (acute, chronic, and granulomatous) and noninvasive forms (allergic fungal sinusitis and mycetoma). CT is superior for detecting bony erosion and hyperdense fungal elements, while MRI excels in evaluating soft tissue and mucosal involvement. Key radiologic signs such as bone destruction, sinus wall thickening, and 'black turbinate sign' aid in early diagnosis, especially in invasive cases. Early imaging signs can be subtle. Early detection is necessary, particularly in immunocompromised patients with acute invasive fungal sinusitis, where rapid intervention is critical.

Summary: Pattern recognition and adequate interpretation of fungal sinusitis are possible using CT and MRI. Imaging can also help identify complications, aiding with reliable diagnosis and prompt intervention.