Preoperative diagnostic value of magnetic resonance imaging for fungal ball of nasal sinuses / 局解手术学杂志

ABSTRACT

Objective To investigate the magnetic resonance imaging (MRI)features and pathologic characteristics of the fungal ball (FB)of the nasal sinuses,for the purpose to provide reference for surgical treatment.Methods The MRI data of 27 patients of nasal sinuses who were diagnosed by surgical pathology were retrospectively analyzed.Of 27 patients,there were 14 male and 13 female,aged from 49 to 86,anverage age 57.6,with course of disease from 6 months to 5 years.All patients preoperatively recieved 1.5 T high field strength mri scan and enhanced scan and functional nasal endoscopic surgical radical resection lesions.Results Maxillary sinus disease,which unilateral 92%(25 /27),bilateral 4% (1 /27),sphenoid sinus disease 4%(1 /27),FB was located in the sinus cavity central.FB isointense signal (com-pared with the white matter of the brain),hypointense on T2WI,DWI (b value =1000)was mixed high and low signal,Gd DTPA enhanced no enhancement,with around mucosal thickening isointense signal,high signal intensity on T2WI,ring enhancement.The histopathology slices of 27 cases were found wrapped fungal hyphae,which confirmed for FB.The pathological basis of FB was fungal silk containing manganese (paramagnetic substances),FB calcium phosphate and calcium sulfate and other substances,due to the magnetic susceptibility effect of T2WI was low signal,DWI high and low mixed signal changes.Conclusion MRI can reflect the histopathological characteristics of FB,and it is of great value in diagnosis and differential diagnosis,as well as providing important imaging evidence for patients undergoing surgical treatment.