Đánh giá việc kết hợp dấu hiệu vôi hóa trung tâm đám mờ với đám mờ hoàn toàn xoang không đồng nhất với trên cắt lớp vi tính trong chẩn đoán viêm xoang do nấm

The aim of this study was to evaluate the combination of central calcification signs and 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. The CT signs of central calcification and the complete heterogeneous sinus opacities were combined together and compared with post-operative fungal testing. Results: fungal sinusitis was diagnosed in 60/70 patients, accounting for 86%. On CT scan, the sign of central calcification had the sensitivity, the specificity, the accuracy, the positive predictive value and the negative predictive value for the diagnosis of fungal sinusitis of 88.3%; 20%; 78.6%; 86.9% and 22.2%, respectively. These values for the sign of complete heterogeneous sinus opacification were 80%; 20%; 71.4%; 85.7% and 14.3%, respectively. When combining these two signs, the sensitivity, the specificity, the accuracy, the positive predictive value and the negative predictive value for fungal sinusitis diagnosis were 68.3%; 60%; 67.1%; 91.1%, and 24%, respectively. Conclusion: Combining two CT signs of central calcification with complete heterogeneous sinus opacities slightly reduced the sensitivity and the diagnosis accuracy but significantly increased the specificity of diagnosing fungal sinusitis by CT.