变应性真菌性鼻窦炎骨质侵蚀的影像学特点及真菌培养分析

胡春华; 魏洪政; 何帅; 刘欣; 李云川

doi:10.13201/j.issn.1001-1781.2017.23.011

变应性真菌性鼻窦炎骨质侵蚀的影像学特点及真菌培养分析

- 1 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科(北京, 100073);
- 2 哈尔滨市第一医院耳鼻咽喉科

详细信息

通讯作者: 李云川, E-mail:1964liyunchuan@163.com

中图分类号: R765.4

收稿日期: 2017-09-14

Imaging charateristics of bony erosion and fungal culture analysis in allergic fungal rhinosinusitis

- 1 Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, 100073, Beijing, China;
- 2 Department of Otorhinolaryngology, the First Hospital of Harbin

More Information

Corresponding author: LI Yunchuan, E-mail: 1964liyunchuan@163.com

Received Date: 14 September 2017

摘要

摘要: 目的: 探讨变应性真菌性鼻窦炎(AFRS)患者骨质侵蚀的影像学特点、真菌培养分布及影响骨质侵蚀发病的相关因素。方法: 回顾性分析60例确诊为AFRS患者的临床资料,根据术前CT、MRI检查结果分析骨质侵蚀的阳性率、侵蚀部位、病变扩展及受累鼻窦窦壁膨胀性扩张的特点,同时取鼻窦分泌物行真菌涂片镜检、接种培养、菌种鉴定,分析鼻窦窦壁膨胀性扩张及致病真菌菌种与骨质侵蚀发病的相关性。采用SPSS 22.0软件对数据进行统计学分析。结果: 60例患者中,合并骨质侵蚀者18例(30%)。骨质侵蚀可发生于各组鼻窦,各组鼻窦之间骨质侵蚀的阳性率差异有统计学意义(P<0.05),其中筛窦受累最常见。眼眶是病变最易扩展的邻近解剖结构,其次为前颅窝。鼻窦窦壁膨胀性扩张与骨质侵蚀的发病差异有统计学意义(P<0.05)。真菌培养的阳性率为51.7%,其中以曲霉菌属最常见,尚未发现特定真菌菌种与骨质侵蚀的发病具有相关性(P>0.05)。结论: 骨质侵蚀是AFRS影像学的重要特点,骨质侵蚀与病变导致的窦壁膨胀性扩张密切相关,病变向邻近解剖结构扩展是骨质侵蚀发生后的自然发展过程,尚未发现可导致骨质侵蚀的特定真菌菌种。
- 鼻窦炎 /
- 真菌 /
- 骨质侵蚀 /
- 计算机断层摄影术 /
- 磁共振成像
Abstract: Objective: To investigate the imaging characteristics of bony erosion, fungal culture and related factors in allergic fungal rhinosinusitis (AFRS).Method: Sixty cases of AFRS were reviewed in this study. The characteristics of Computed Tomography and Magnetic Resonance Imaging including positive rate of bony erosion, eroded sites, disease extension and sinus expansion were summarized. Fungal culture and identification of nasal secretion were done. The correlation between the degree of sinus expansion, species of fungi and bony erosion was evaluated by statistical analysis.Result: Of the 60 patients, 18 (30%) had bony erosion. There was a significant difference in the proportion of bone erosion among the sinuses (P<0.05). The most commonly eroded site was the ethmoid sinus. The orbit were the most common adjacent anatomic spaces to exhibit disease extension, and anterior cranial fossa is the second most common. Statistical analysis revealed a significant association(P<0.05)of bone erosion with sinus expansion. The positive rate of fungal culture was 51.3%, among which the most common is Aspergillus. Statistical analysis shows no association(P>0.05)of bone erosion with specific fungi.Conclusion: Bone erosion is an important imaging feature of AFRS. Bone erosion may cause by sinus expansion. Extension of disease into the orbit or intracranial cavity results from a natural progression of disease after erosion occurs. Specific fungal species that can cause bone erosion was found.
- sinusitis /
- fungi /
- bony erosion /
- computed tomography /
- magnetic resonance imaging

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