Abstract

目的 探讨慢性侵袭性真菌性鼻窦炎的CT和MRI表现及诊断价值.方法回顾性分析经手术、组织病理学证实的10例慢性侵袭性真菌性鼻窦炎的影像学资料.结果慢性侵袭性真菌性鼻窦炎发生于蝶窦5例,上颌窦3例,筛窦2例.CT表现:受累窦腔内充以软组织影,其中1例伴斑点状钙化;窦壁骨质破坏,同时伴周围骨质增生肥厚.MRI表现:T1WI为低信号(与脑实质比较,以下相同)2例,等信号7例;T2WI信号不均匀, 7例以低信号为主,2例以高信号为主;增强后病变明显强化.侵犯邻近结构:眼眶9例,其中6例累及眶尖区,可见不规则软组织肿块影,与邻近眼外肌分界不清楚,7例包绕视神经;6例侵犯海绵窦,可见形态不一的软组织影;脑膜增厚、强化5例,3例侵犯脑实质,表现为水肿1例,肉芽肿2例;4例侵犯翼腭窝及颞下窝;3例鼻咽部软组织增厚;2例上颌神经和1例下颌神经明显增粗、强化;3例面颊部软组织肿胀;1例硬腭骨质破坏.结论窦壁骨质破坏伴硬化、MR T2WI低信号、易侵犯眶尖及海绵窦为本病特征性影像学表现.结合CT和MRI 2种检查方法能够对本病的诊断、鉴别和治疗提供更可靠的信息。

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