KHẢO SÁT GIÁ TRỊ VIỆC KẾT HỢP DẤU HIỆU TỔN THƯƠNG XOANG MỘT BÊN VỚI ĐÁM MỜ XOANG HOÀN TOÀN, KHÔNG ĐỒNG NHẤT TRÊN CẮT LỚP VI TÍNH TRONG CHẨN ĐOÁN VIÊM XOANG DO NẤM

Abstract

Purpose: To investigate the value of combining unilateral sinus lesions with complete, heterogeneous sinus opacities on computed tomography (CT) in the diagnosis of fungal sinusitis. Material and methods: Descriptive study on 70 patients with chronic rhinosinusitis examined at Hanoi Medical University Hospital during the period from January 2022 to July 2023. These patients were all had endoscopy and multi-slices CT scan of the sinuses, then had endoscopic sinus surgery and confirmed diagnosis of fungal sinusitis by post-operative fungal testing. Signs of unilateral sinus lesion and complete, heterogeneous sinus opacities on CT were combined together and compared with post-operative fungal testing to investigate the value of combining these two signs. Results: Fungal sinusitis was diagnosed in 60/70 patients, accounting for 86%. On CT scan, the sign of unilateral sinus lesion location had the sensitivity, the specificity, the diagnostic accuracy, the positive predictive value, and the negative predictive value for the diagnosis of fungal sinusitis of 91.7%; 0%; 78.6%; 84.6% and 0%, respectively. These values for the complete, heterogeneous sinus opacities sign were 80%;  20%; 71.4%; 85.7% and 14.3%, respectively. When combining the sign of unilateral sinus lesion location with the sign of complete, heterogeneous sinus opacification, the sensitivity, the specificity, the diagnosis accuracy, the positive predictive value, the negative predictive value of CT scan for fungal sinusitis diagnosis were 70%; 60%; 68.6%; 91.3% and 25%, respectively Conclusion: Combining two signs of unilateral and complete, heterogeneous sinus opacities, although reduced the sensitivity and the diagnostic accuracy but increased the specificity for the diagnosis of fungal sinusitis by CT.