[Value of CT in allergic fungal sinusitis (AFS)].
OBJECTIVE
To assess the value of CT for diagnosis and follow-up of AFS. Evaluation of characteristic CT features of AFS.


METHODS
Retrospective review of 12 cases of AFS presenting with all published diagnostic criteria (1) chronic rhinosinusitis refractory to standard management (2) CT features of chronic sinusitis (3) anatomopathologic, immunoallergologic, biochemical and mycologic criteria. CT findings were correlated with surgical findings and reviewed by one ENT and two radiologists to assess the diagnostic value of different CT features, alone or in association.


RESULTS
AFS was isolated in 6 cases, and associated with allergic bronchopulmonary aspergillosis (ABPA) in 6 cases. CT showed pan- or polysinusitis, unilateral or bilateral, with mucosal thickening, sinus opacification frequently heterogeneous, bony changes, fluid trapping, and with pseudotumoral appearance in 3 cases.


CONCLUSIONS
CT findings alone are not specific or pathognomonic but may suggest AFS in the correct clinical or immunoallergologic setting. It may alert the physician to the need for complementary work-up, exclude the presence of associated lung disease, and better adapt treatment and follow-up.
Braun
J  J
J
Service ORL, Hôpital de Hautepierre, Strasbourg Cedex, France. braun.jean-jacques@wanadoo.fr
Riehm
S
S
Veillon
F
F
D000328:Adult; D000908:Antibodies, Fungal / Q000032:analysis; D001228:Aspergillosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000276:immunology*; D001229:Aspergillosis, Allergic Bronchopulmonary / Q000150:complications*; D001230:Aspergillus / Q000276:immunology / Q000302:isolation & purification; D001232:Aspergillus fumigatus / Q000276:immunology / Q000302:isolation & purification; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D005658:Fungi / Q000276:immunology; D005670:Fusarium / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011852:Radioallergosorbent Test; D012130:Respiratory Hypersensitivity / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D012189:Retrospective Studies; D012852:Sinusitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000276:immunology / Q000382:microbiology*; D012882:Skin Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000908:Antibodies, Fungal; D007073:Immunoglobulin E