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目的 :探讨早期慢性侵袭性真菌性鼻 鼻窦炎 (CIFRS)鼻窦CT特征及其诊断意义。方法 :以病理学诊断为依据 ,对 18例诊断为早期CIFRS的鼻窦CT影像学表现进行回顾性分析 ,并与 35例非侵袭性真菌性鼻 鼻窦炎 (NIFRS)进行比较。结果 :早期CIFRS鼻窦CT表现为 :14例 (77.8% )为单窦病变 ,多见于上颌窦 ,其次是蝶窦、筛窦 ;多窦病变为 4例 (2 2 .2 % ) ;病变鼻窦内表现为密度不均匀不透光影 ;单窦病变者窦腔均不同程度向邻近鼻窦、鼻腔或眼眶膨出 ;12例 (6 6 .7% )病变鼻窦内可见钙化斑或点 ,CT值为 80～ 16 0Hu ;7例 (38.9% )病变鼻窦显示窦壁骨质破坏 ,其中 2例同时有中鼻甲大部分破坏 ,1例同时有鼻中隔破坏。与NIFRS鼻窦CT比较 ,CIFRS多窦病变比例和骨质破坏比例较高 ,且破坏程度较大。结论 :早期CIFRS鼻窦CT表现病变多窦侵犯、病变鼻窦骨质破坏的机率略高 ,但总体特征与NIFRS基本相似 ,因此鼻窦CT对早期CIFRS的诊断无特异性意义。
Objective: To investigate the CT features and its diagnostic significance of sinusitis in patients with early chronic fungal rhinosinusitis (CIFRS). Methods: Based on pathological diagnosis, 18 cases of CIFRS with early diagnosis of CT were retrospectively analyzed and compared with 35 cases of noninvasive fungal rhinosinusitis (NIFRS). Results: The CT findings of early CIFRS were 14 cases (77.8%) with single sinus lesion, more common in the maxillary sinus, followed by the sphenoid sinus and ethmoid sinus. The lesions of multiple sinus were in 4 cases (22.2%), The results showed that the density of the sinus was not uniform. The sinuses of single sinus lesion were bulging to the adjacent sinuses, nasal cavity or orbit with varying degrees. Calcified plaques or spots were found in the sinuses of 12 patients (66.7%) with CT values of 80 ~ 160Hu; 7 cases (38.9%) of sinus lesions showed sinus wall destruction, including 2 cases of middle turbinate most of the damage, while 1 case of nasal septal damage. Compared with NIFRS sinus CT, the proportion of CIFRS with multiple sinus lesions and the rate of bone destruction were higher, and the degree of destruction was greater. CONCLUSIONS: Early CIFRS sinus CT is characterized by multiple sinus invasion, and the probability of lesion sinus osseous destruction is slightly higher. However, the overall characteristics are similar to those of NIFRS. Therefore, sinus CT has no specific significance in the early diagnosis of CIFRS.