Clinical and radiologic features of fungal diseases of the paranasal sinuses.

Objective: To document the clinical and imaging characteristics of fungal rhinosinusitis (FRS).

Methods: Imaging studies of 28 patients with FRS were retrospectively analyzed, considering the type of fungal disease, location, signal characteristics, bone changes, expansion, and extrasinus extension.

Results: Acute invasive FRS showed unilateral pacifications of the sinonasal cavity, perisinus fat infiltration and/or bone destruction. Chronic invasive FRS demonstrated masslike hyperattenuating soft tissue, with bony destruction. The soft tissue changes were hypointense on T1 and markedly hypointense on T2-weighted images. In allergic FRS, hyperattenuating soft tissue causing paranasal expansion due to allergic mucin was observed on CT. Fungus ball presented as a hyperattenuating lesion with calcifications within a single sinus.

Conclusions: The radiological features of each type of FRS are distinctive and should afford a specific diagnosis in the proper clinical setting.