Calcification in chronic maxillary sinusitis: comparison of CT findings with histopathologic results.
OBJECTIVE
It is important to differentiate fungal from nonfungal sinusitis in order to determine the optimal treatment for chronic sinusitis. The purpose of this study was to describe the CT findings of calcifications in chronic fungal and nonfungal maxillary sinusitis.


METHODS
Five hundred ten patients with pathologically proved chronic maxillary sinusitis were studied with unenhanced CT before undergoing sinonasal surgery. In 36 patients, the CT scans were reviewed retrospectively to ascertain the shape and location of intrasinus calcifications.


RESULTS
Calcifications were found in 20 (51%) of 39 patients with fungal sinusitis and in 16 (3%) of 471 patients with nonfungal sinusitis. Direct histopathologic correlation was performed in two of 16 patients with nonfungal sinusitis who had intrasinus calcification. The location of intrasinus calcification was central in 95% of the patients with fungal sinusitis and peripheral in 81% of those with nonfungal sinusitis. Although calcifications with a nodular or linear shape were seen in both fungal and nonfungal sinusitis, fine punctate type calcifications were seen only in those with fungal sinusitis (50%) and round or eggshell type calcifications only in those with nonfungal sinusitis (19%).


CONCLUSIONS
Intrasinus calcifications are different in location and shape between fungal and nonfungal maxillary sinusitis. Although intrasinus calcification is uncommon in nonfungal sinusitis, the CT finding of intrasinus calcification may be helpful for differentiating fungal from nonfungal maxillary sinusitis.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001228:Aspergillosis / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D002908:Chronic Disease; D003287:Contrast Media; D003937:Diagnosis, Differential; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009181:Mycoses / Q000145:classification / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010347:Patient Care Planning; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed