NONINVASIVE ASPERGILLOSIS OF THE PARANASAL SINUSES - CT AND MRI FINDINGS

Aspergillosis is the most common fungal infection of the paranasal sin uses, and needs to be recognized because it requires surgical removal. Twenty proven cases of aspergillosis of the paranasal sinuses are rep orted here. CT was performed in all the cases and MRI in 2 cases. The maxillary sinus was affected in 19 patients and the sphenoid sinus in 1. Mycosis was unilateral in all but 1 of the cases. Foci of increased attenuation at CT were observed in 18 cases, with calcification in 10 cases and/or dental material in 13 cases. An increased bony wall thic kness was observed in 16 cases. All the patients but 1 had at least on e of the signs. At MRI the fungal mass displayed a hypointense signal on T1- and T2-weighted images. No enhancement was noted on post-contra st T1- weighted images. The diagnosis of paranasal sinus aspergillosis is suggested by the CT findings, when a hyperdense mass with calcific ations and/or dental material is noted with thickening of the sinus wa ll. MRT may have a complementary diagnostic role in doubtful cases.