Analysis of computed tomography features of fungal sinusitis and their correlation with nasal endoscopy and histopathology findings

Abstract

Objective: The purpose of this study was to analyze the computed  tomography (CT) features of fungal sinusitis and to correlate them with nasal endoscopy and histopathological findings.
Materials and Methods: Our study included 16 patients of either sex and any age group who presented in the otorhinolaryngology clinic at our hospital and had evidence of definite sinonasal disease on clinical  evaluation. Multidetector CT was carried out on Somatom definition AS + 128 slice CT Machine by Siemens Germany Ltd. Axial sections were  performed with the plane of data acquisition parallel to the hard palate and slice thickness of 3 mm, reconstructions at 0.75 mm in coronal and sagittal planes. Scanning parameters included 190 mA S, 120 KV and tube rotation time of 0.5 s. Provisional CT diagnosis was made in all cases and  correlated with nasal endoscopy and histopathological findings.
Results: Out of total 16 patients, 12 showed immunocompromised status and had infection with mucormycosis. Out of 12, 9 patients (75%) showed extension of disease beyond the sinonasal cavities and 4 (33.3%) showed
evidence of bone destruction. All patients with candidiasis showed  soft.tissue attenuation with hyperdense areas on CT scan. Nearly, 66.6% patients with aspergillosis showed soft.tissue attenuation with hyperdense
areas and expansion of sinonasal cavities. Fifteen patients (93%) were proved to be of fungal sinusitis on histopathology. One patient of  non.specific granulomatous infection showed bone destruction and  mimicked fungal sinusitis on CT.
Conclusions: In the present study, fungal sinusitis could be correctly diagnosed on CT with high accuracy. Thus, understanding the different CT findings of fungal sinusitis allows the radiologist to play a crucial role in the diagnosis and prompt treatment.

Keywords: Allergic, fungal, invasive, sinusitis