MDCT Features of Fungal Rhinosinusitis: How to Differentiate From Other Rhinosinusitis?

Multidetector computed tomography (MDCT) is the most common modality for the evaluation of the sinonasal region which can determines the extent of disease, readily depicts osseous changes and is sensitive for detecting calcification. Radiologists need to be familiar with the different patterns of sinonasal diseases in MDCT. Fungal rhinosinusitis is relatively common and results in clinical presentations with a broad spectrum of severity. Fungal sinusitis is divided into two categories, invasive and non- invasive. The invasive category is defined by the presence of fungal hyphae in the mucosa, submucosa, bone, or blood vessels. The acute invasive fungal sinusitis is life-threatening so early diagnosis is crucial. In the non-invasive category fungal material fills the sinuses without tissue invasion, including localized fungal colonization, fungal ball, and allergic fungal rhinosinusitis. Knowledge of the MDCT features of the disease and the clinical findings will aid diagnosis, provide information for surgical planning, and ultimately improve patient outcomes.