MÔ TẢ HÌNH ẢNH VÀ ĐÁNH GIÁ GIÁ TRỊ CHẨN ĐOÁN CỦA CẮT LỚP VI TÍNH TRÊN BỆNH NHÂN VIÊM XOANG MẠN DO NẤM TẠI CẦN THƠ NĂM 2025 - 2026

Abstract

Background: Fungal rhinosinusitis is a chronic inflammatory condition of the paranasal sinuses characterized by the presence of fungi causing damage to the mucosa and surrounding tissues. Computed tomography (CT) plays a crucial role in identifying the etiology of chronic rhinosinusitis. Objective: To describe CT imaging features and evaluate the diagnostic value of computed tomography in the patients with chronic fungal rhinosinusitis in a few Can Tho City Hospitals during 2025–2026. Materials and methods: A cross-sectional study was conducted on 78 patients with chronic rhinosinusitis treated at Can Tho Central General Hospital and Can Tho Otorhinolaryngology Hospital from 2025 to 2026. Results: On CT scans, only one single sinus invovement accounted for 55.3% of the patients, followed by two sinuses (28.9%) and more than two sinuses (15.8%); the maxillary sinus was affected in 100% of cases. Mucosal thickening was observed in 89.5% of patients. Sinus opacification was mainly partial (52.6%) or complete (44.7%). Characteristic signs such as calcification (52.6%) and bony wall thickening (44.7%) were observed at notable rates, whereas bone erosion and invasion were uncommon (both 5.3%). The mean Lund– Mackay score was 5.59 ± 1.59, with the majority of patients classified as grade 2 (5–9 points, 73.1%). Compared with the gold standard of fungal endoscopy and/or histopathology, CT demonstrated a sensitivity of 86.8%, a specificity of 82.5%, and an overall accuracy of 84.6% in diagnosing fungal rhinosinusitis. The positive likelihood ratio (LR⁺) was 4.96 and the negative likelihood ratio (LR⁻) was 0.16. Conclusion: Computed tomography (CT) is a valuable tool for diagnostic orientation; however, it cannot replace fungal examination and/or histopathological examination for establishing a definitive diagnosis.