Clinical and radiologic features of fungal diseases of the paranasal sinuses

J Comput Assist Tomogr. 2012 Sep-Oct;36(5):570-6. doi: 10.1097/RCT.0b013e318263148c.

Abstract

Objective: To document the clinical and imaging characteristics of fungal rhinosinusitis (FRS).

Methods: Imaging studies of 28 patients with FRS were retrospectively analyzed, considering the type of fungal disease, location, signal characteristics, bone changes, expansion, and extrasinus extension.

Results: Acute invasive FRS showed unilateral pacifications of the sinonasal cavity, perisinus fat infiltration and/or bone destruction. Chronic invasive FRS demonstrated masslike hyperattenuating soft tissue, with bony destruction. The soft tissue changes were hypointense on T1 and markedly hypointense on T2-weighted images. In allergic FRS, hyperattenuating soft tissue causing paranasal expansion due to allergic mucin was observed on CT. Fungus ball presented as a hyperattenuating lesion with calcifications within a single sinus.

Conclusion: The radiological features of each type of FRS are distinctive and should afford a specific diagnosis in the proper clinical setting.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Mycoses / diagnosis*
  • Mycoses / microbiology*
  • Mycoses / pathology
  • Paranasal Sinus Diseases / diagnosis*
  • Paranasal Sinus Diseases / microbiology*
  • Paranasal Sinus Diseases / pathology
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods

Substances

  • Contrast Media