Eosinophilic fungal rhinosinusitis (EFRS): a distinct CT/MRI-entity? A European experience.
OBJECTIVE
To determine the value of radiological features in the diagnosis of Eosinophilic Fungal Rhinosinusitis (EFRS).


METHODS
Retrospective review of the radiological materials of 65 patients with documented Eosinophilic Fungal Rhinosinusitis treated at the same institution.


METHODS
Evaluation by the ENT surgeon and the head and neck radiologist.


RESULTS
EFRS was more common in female patients in this series. Fifty-four (83%) patients were above 30 years of age, with a peak of 18 patients (27.7%) in the seventh decade. All the patients except one (98.5%) showed bilateral mucosal thickening on unenhanced CT scans. Thirty-eight patients (58%) showed increased intrasinus attenuation on unenhanced CT scans. Thirty-seven patients (57%) showed opacification of at least one sinus; 25 (38%) showed osteitis; 11 (17%) had erosion of the sinus wall and only one patient showed minor expansion of an involved sinus. In 6 patients, typical hyperattenuation patterns on CT scans, together with distinctive MRI images, were highly suggestive of EFRS.


CONCLUSIONS
Our data show that hyperattenuation on CT images with bone window settings suggests the presence of EFRS. This hyperattenuation is more clearly seen with soft-tissue window settings. When necessary, adjunctive MRI can provide information which might be highly predictive for the diagnosis of EFRS. However, non-specific imaging findings of chronic rhinosinusitis (CRS) should also be seen as possible EFRS pathology.
Vlaminck
S
S
Department of Otorhinolaryngology, St-Jan General Hospital, Bruges, Belgium. stephan.vlaminck@azbrugge.be
Casselman
J
J
De Groef
K
K
Van den Berghe
I
I
Kuhweide
R
R
Joniau
S
S
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004802:Eosinophilia / Q000175:diagnosis* / Q000382:microbiology; D004804:Eosinophils / Q000276:immunology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000382:microbiology; D009297:Nasal Mucosa / Q000473:pathology; D012189:Retrospective Studies; D012220:Rhinitis / Q000175:diagnosis* / Q000382:microbiology; D012852:Sinusitis / Q000175:diagnosis* / Q000382:microbiology; D014057:Tomography, X-Ray Computed / Q000379:methods*