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Clinical and Radiologic Features of Fungal Diseases of the Paranasal Sinuses

Ilica, Ahmet Turan MD; Mossa-Basha, Mahmud MD; Maluf, Fernando MD; Izbudak, Izlem MD; Aygun, Nafi MD

Journal of Computer Assisted Tomography: September/October 2012 - Volume 36 - Issue 5 - p 570–576
doi: 10.1097/RCT.0b013e318263148c

Objective: To document the clinical and imaging characteristics of fungal rhinosinusitis (FRS).

Methods: 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.

Results: 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.

Conclusion: The radiological features of each type of FRS are distinctive and should afford a specific diagnosis in the proper clinical setting.

From the Russell H. Morgan Department of Radiology, The Johns Hopkins Medical Institutions, Baltimore, MD.

Received for publication March 8, 2012; accepted June 5, 2012.

Reprints: Ahmet Turan Ilica, MD, The Johns Hopkins Medical Institutions, 600 N Wolfe St, Phipps B-100F Baltimore, MD 21287 (e-mail:

The authors report no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.