Allergic fungal sinusitis: CT findings.
OBJECTIVE
To determine the computed tomographic (CT) findings in patients with allergic fungal sinusitis.


METHODS
The authors retrospectively reviewed CT scans and surgical and histopathologic reports in 45 patients (27 male, 18 female; age range, 8-68 years) with allergic fungal sinusitis from multiple institutions. The median age (25 years) and demographics of the patients were determined. Two head and neck radiologists together evaluated the CT scans for the presence of intrasinus high-attenuation areas, extent of sinus involvement, bone expansion and thinning, bone erosion, and extension of disease into the adjacent soft tissues.


RESULTS
Allergic fungal sinusitis was more common in male patients and in patients aged 20-30 years. All patients had increased intrasinus attenuation at non-contrast material-enhanced CT. Multiple sinus involvement occurred in 43 patients. Bilateral involvement was more common than unilateral disease. Forty-four patients had complete opacification of at least one of the involved sinuses; 43 of these patients had expansion of an involved sinus, 42 had remodeling and thinning of the bony sinus walls, and 41 had erosion of the sinus wall.


CONCLUSIONS
Allergic fungal sinusitis is a distinct clinical entity with nonspecific symptoms that may be initially suggested by the CT findings. These findings should alert the clinician to the possibility of allergic fungal sinusitis and prompt other diagnostic studies to establish the diagnosis and treatment plan.
Mukherji
S K
SK
Department of Radiology, University of North Carolina School of Medicine, Chapel Hill 27599-7510, USA.
Figueroa
R E
RE
Ginsberg
L E
LE
Zeifer
B A
BA
Marple
B F
BF
Alley
J G
JG
Cooper
L L
LL
Nemzek
W R
WR
Yousem
D M
DM
Jones
K R
KR
Kupferberg
S B
SB
Castillo
M
M
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001847:Bone Diseases / Q000000981:diagnostic imaging; D016723:Bone Remodeling; D002648:Child; D002908:Chronic Disease; D003287:Contrast Media; D015521:Ethmoid Sinusitis / Q000000981:diagnostic imaging / Q000382:microbiology; D005145:Face / Q000382:microbiology; D005147:Facial Bones / Q000000981:diagnostic imaging; D005260:Female; D015522:Frontal Sinusitis / Q000000981:diagnostic imaging / Q000382:microbiology; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging / Q000382:microbiology; D008875:Middle Aged; D009181:Mycoses / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D010347:Patient Care Planning; D012130:Respiratory Hypersensitivity / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012737:Sex Factors; D012852:Sinusitis / Q000000981:diagnostic imaging / Q000276:immunology / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D015524:Sphenoid Sinusitis / Q000000981:diagnostic imaging / Q000382:microbiology; D014057:Tomography, X-Ray Computed
D003287:Contrast Media