ĐẶC ĐIỂM HÌNH ẢNH NỘI SOI MŨI XOANG, CT-SCAN VÀ MRI CỦA VIÊM XOANG DO NẤM XÂM LẤN CẤP TÍNH

Abstract

Objective: To describe the imaging characteristics of nasal endoscopy, CT-scan, and MRI in patients with histopathologically confirmed AIFRS. Materials and Methods: A retrospective, descriptive study was conducted on 90 patients, divided into three groups: 30 AIFRS patients, 30 patients with acute bacterial rhinosinusitis, and 30 patients with sinonasal cancer. Clinical, endoscopic, CT-scan, and MRI data were collected and analyzed. Results: The AIFRS group had a significantly higher rate of diabetes mellitus compared with the non-AIFRS group (63.3% versus 31.7%, p=0.004). On endoscopy, “intraoperative mucosal necrosis” was the characteristic sign (86.2% in AIFRS compared with <24% in other groups). On CT-scan, common findings were “perimaxillary sinus fat stranding” (63.3%) and “sphenoid bone destruction” (46.7%), while “extraocular muscle enlargement” was a prominent finding (43.3% in AIFRS compared with 0% in the bacterial group). MRI revealed vascular invasion signs as the most characteristic features, notably “sphenopalatine artery occlusion” (79.3% compared with <8%), “cavernous sinus thrombosis” (26.7% compared with <4%), and “internal carotid artery stenosis/occlusion” (30.0% compared with 0%) in the other groups. Conclusion: AIFRS presents with distinct imaging characteristics across all three modalities. Endoscopy detects mucosal necrosis; CT is sensitive to bone destruction and extrasinus soft tissue infiltration; MRI excels at identifying vascular complications. Early recognition of these signs is critical for diagnostic orientation and treatment planning.