真菌性副鼻窦炎25例临床症状与CT诊断分析

    Clinical symptoms and CT diagnosis of fungous sinusitis: an analysis of 25 cases

    • 摘要: 目的:分析真菌性副鼻窦炎的临床表现和CT征象,探讨真菌性副鼻窦炎CT特征性表现及诊断价值。方法:25例经手术后病理证实为真菌性副鼻窦炎的临床资料,分析其CT表现。结果:25例临床症状以鼻塞、头痛为主,其次是脓鼻涕、回吸性血涕以及嗅觉异常。CT表现为单侧或双侧、单个或多个副鼻窦腔内不均匀的软组织密度影,窦腔缩小、闭塞消失。其中19例窦腔内可见斑块、斑点状及条状钙化影;上颌窦开口扩大13例;上颌窦壁骨质吸收变薄4例。结论:真菌性副鼻窦炎的诊断主要根据临床症状及CT检查,CT检查可以良好地显示病变密度、范围和副鼻窦解剖结构,病变内出现钙化影是诊断真菌性副鼻窦炎的可靠依据。CT检查是本病首选且有效的诊断方法。

       

      Abstract: Objective: To analyze the clinical symptoms and CT findings of fungous sinusitis, and to assess the value of CT in diagnosis of the disease. Methods: The clinical symptoms and CT features of 25 cases of fungous sinusitis which had been proved by pathology after operation were analyzed retrospectively. Results: The main clinical features of fungous sinusitis were nasal obstruction,headache,purulent nasal discharge,suction of blood mucus and olfactory abnormalities; CT scans showed inhomogeneous soft tissue density involving the unilateral or bilateral, single or multiple paranasal sinus cavities,and sinus cavity narrowing. Plaque, spotted and strip calcification were observed in the sinus cavity of 19 cases,and 13 cases were accompanied by enlarged maxillary sinus ostium and 4 cases bone absorption wall thinning in the maxillary sinus. Conclusions: The diagnosis of fungous sinusitis relies mainly on the clinical symptoms and CT examination. The lesion density, scope and paranasal sinus anatomic structure can be displayed clearly in CT scan. Abnormal calcification in the lesion is a reliable sign for the diagnosis of fungous sinusitis, and CT scan is the first and the most effective diagnostic method.

       

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