Abstract:【Objective】 To compare the clinical value of MRI and multi slice spiral CT in the diagnosis of allergic fungal sinusitis (AFRS). 【Methods】 A total of 84 patients with suspected AFRS admitted to our hospital from January 2017 to June 2021 were selected. All patients underwent MRI and multi-slice spiral CT examinations,using pathological diagnosis as the "gold standard". The diagnostic results of MRI and multi slice spiral CT were recorded,and the effectiveness and consistency of MRI and multi slice spiral CT in diagnosing AFRS were analyzed. 【Results】 Eighty out of 84 suspected AFRS patients were diagnosed as AFRS by pathological examination. Multi slice spiral CT diagnosed 78 cases of AFRS,showing 53 cases of maxillary sinus involvement,36 cases of maxillary sinus ostium enlargement,and 20 cases of bone hyperplasia and sclerosis causing sinus cavity narrowing; There were 19 cases of residual air bubbles,20 cases of soft tissue density showing a slightly higher density shadow in the form of strips (or patches),presenting a characteristic "ground glass like change" (more obvious in the soft tissue window),with a CT value of (96.84±8.06) HU,58 cases of low density soft tissue filling,with a CT value of (34.54±5.79) HU; 66 cases showed uneven intraluminal density and calcification; There were 23 cases of hyperplasia and sclerosis of the maxillary sinus wall,40 cases of bone resorption and destruction of the maxillary sinus wall,8 cases of bone resorption and destruction of the inferior ethmoid sinus wall,and 7 cases of absorption and destruction of the nasal septum. There were 79 cases of AFRS diagnosed by MRI. T1WI showed equal or slightly lower signal intensity around the sinus cavity. T2WI showed uniform or mixed high signal. STIR_ LongTE presents a slightly higher signal; The slightly low signal on T1WI and the low signal on T2WI were basically consistent with the location of CT calcification,and the signal on T2WI was significantly lower than that on T1WI. The sensitivity and specificity of multi-slice spiral CT in the diagnosis of AFRS were 97.50% and 100.00%,respectively. The sensitivity and specificity of MRI in the diagnosis of AFRS were 98.75% and 100.00%,respectively. There was no statistically significant difference between the two (P>0.05). The consistency Kappa value between pathological diagnosis and multi-slice spiral CT and MRI diagnosis of AFRS was 0.908 and 0.917,respectively. The consistency Kappa value between multi-slice spiral CT and MRI diagnosis was 0.901. 【Conclusion】 Multislice spiral CT and MRI have similar diagnostic efficacy in AFRS. CT can be the first imaging method for screening AFRS,and can assist MRI in the diagnosis of AFRS patients who cannot be diagnosed with multislice spiral CT.
王军, 孙艳莉. MRI与多层螺旋CT诊断变应性真菌性鼻窦炎的临床价值[J]. 医学临床研究, 2023, 40(3): 374-377.
WANG Jun, SUN Yan-li. Clinical Value of MRI and Multi-slice Spiral CT in the Diagnosis of Allergic Fungal Sinusitis. JOURNAL OF CLINICAL RESEARCH, 2023, 40(3): 374-377.
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