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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.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.