To document the clinical and imaging characteristics of fungal rhinosinusitis (FRS). Imaging studies of 28 patients with FRS were retrospectively analyzed, considering the type of fungal disease, location, signal characteristics, bone changes, expansion, and extrasinus extension. Acute invasive FRS showed unilateral pacifications of the sinonasal cavity, perisinus fat infiltration and/or bone destruction. Chronic invasive FRS demonstrated masslike hyperattenuating soft tissue, with bony destruction. The soft tissue changes were hypointense on T1 and markedly hypointense on T2-weighted images. In allergic FRS, hyperattenuating soft tissue causing paranasal expansion due to allergic mucin was observed on CT. Fungus ball presented as a hyperattenuating lesion with calcifications within a single sinus. The radiological features of each type of FRS are distinctive and should afford a specific diagnosis in the proper clinical setting.
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