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中国真菌学杂志 2020, Vol. 15  Issue (5): 283-287.

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真菌性鼻-鼻窦炎的CT影像诊断分析

陈易鑫1, 闫师玲1, 朱银民2, 范静平3, 陈晓平1, 周恩晖1, 薛晓成1, 张燚1   

  1. 1. 上海市浦东新区公利医院耳鼻咽喉科, 上海 200135;
    2. 上海市浦东新区公利医院影像科, 上海 200135;
    3. 海军军医大学第二附属医院耳鼻咽喉科, 上海 200003
  • 收稿日期:2020-03-23 出版日期:2020-10-28 发布日期:2020-10-28
  • 通讯作者: 张燚,E-mail:zy_mars@hotmail.com E-mail:zy_mars@hotmail.com
  • 作者简介:陈易鑫,男(汉族),本科,住院医师.E-mail:1520235719@qq.com
  • 基金资助:

    上海市浦东新区学科带头人项目(PWRd2018-05),上海市浦东新区公利医院拔尖人才项目(GLRb2018-02),上海市卫生系统重点专科建设项目(ZK2019C-06)

CT imaging diagnostic analysis of fungal rhino-sinusitis

CHEN Yi-xin1, YAN Shi-ling1, ZHU Yin-min2, FAN Jing-ping3, CHEN Xiao-ping1, ZHOU En-hui1, XUE Xiao-cheng1, ZHANG Yi1   

  1. 1. Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Pudong New Area Gongli Hospital, Shanghai 200135, China;
    2. Department of Radiology, Shanghai Pudong New Area Gongli Hospital, Shanghai 200135, China;
    3. Department of Otorhinolaryngology Head andNeck Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
  • Received:2020-03-23 Online:2020-10-28 Published:2020-10-28

摘要:

目的 分析真菌性鼻-鼻窦炎的CT影像学特征,并结合临床症状,以提高对其诊断水平。方法 收集我院2014~2019年期间经鼻内窥镜手术治疗的84例真菌性鼻-鼻窦炎患者作为研究对象,结合临床症状及主客观评分之间的相关性,回顾性分析经手术、病理证实患者的影像学特征。结果 研究对象的影像学特点表现为:本病病灶多发生在上颌窦,且大多数病例累及2个或以上鼻窦;多数为单侧发病,双侧发病的病例较少见;窦腔内均表现为密度不均的软组织影,大多数病变窦腔内可见高密度钙化影,其CT值平均范围71~494 Hu之间;多数腔内可见轻度、局限的窦壁增厚或骨质破坏,仅1例研究对象骨质破坏范围累及颅内;84例真菌性鼻-鼻窦炎患者VAS评分为(8.75±3.51)分,Lund-Mackay评分为(6.27±3.51)分,Lund-Mackay评分与VAS评分呈显著相关(r=0.76,P<0.01)。结论 鼻窦腔内病灶中的高密度钙化影是真菌性鼻-鼻窦炎的影像学典型特征,影像学表现的严重程度及受累范围与患者的症状程度存在关联,有助于围手术期的综合评估,以提高患者的治愈率及生活质量。

关键词: 真菌性鼻-鼻窦炎, 临床症状, CT, 诊断

Abstract:

Objective To analyze the CT imaging features of fungal rhino-sinusitis with the clinical symptoms, aimed at improving the diagnostic level for fungal rhino-sinusitis. Methods The data of 84 fungal rhino-sinusitis patients underwent endoscopic sinus surgery from 2014 to 2019 were collected, the correlation between clinical symptoms with subjective and objective scores was integrated, retrospective analysis of CT imaging features of patients with surgical and pathological confirmation was performed. Results The study of 84 cases of CT imaging characteristic features showed that most of the lesions occurred in the maxillary sinus and most cases involved two or more sinuses,the vast majority of the cases were unilateral andinvolvement of bilateral was seldom seen. All cases showed uneven soft tissue shadows, most cases were well-distributed high density calcification shadow in the sinus cavity with the CT value ranged between 71-494 Hu.The bone destruction or thickened of sinus wall could be seen as slight and limited in most of the sinuses, only one case involved intracranial bone destruction. The VAS score of 84 fungal rhino-sinusitis patients was 8.75±3.51 and the Lund-Mackay score was 6.27±3.51. There was significantly correlation between VAS score and Lund-Mackay CT score(r =0.76,P<0.01). Conclusion The study showed that the high density calcification shadow in the lesions of sinus cavity was the typical imaging features for the diagnosis of fungal rhino-sinusitis, moreover, the severity and extent of imaging manifestations were correlated with the degree of symptoms of patients, which would be helpful for comprehensive evaluation in perioperative period to improve the cure rate and quality of life.

Key words: fungal rhino-sinusitis, clinical symptoms, computed tomography, diagnose

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