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