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Imaging Features of Invasive and Noninvasive Fungal Sinusitis: A Review¹

¹ From the Department of Radiology, University of Texas Health Science Center, San Antonio. Recipient of a Certificate of Merit award for an education exhibit at the 2002 RSNA Annual Meeting. Received November 9, 2006; revision requested December 11 and received January 10, 2007; accepted January 11. All authors have no financial relationships to disclose. Address correspondence to M.A., Department of Radiology, Geisinger Medical Center, 100 N Academy Ave, Danville, PA 17822 (e-mail: maribandi1{at}geisinger.edu).

Fungal sinusitis was once considered a rare disorder but is now reported with increasing frequency throughout the world. The classification of fungal sinusitis has evolved in the past two decades, and this entity is now thought to comprise five subtypes. Acute invasive fungal sinusitis, chronic invasive fungal sinusitis, and chronic granulomatous invasive fungal sinusitis make up the invasive group, whereas noninvasive fungal sinusitis is composed of allergic fungal sinusitis and fungus ball (fungal mycetoma). These five subtypes are distinct entities with different clinical and radiologic features. The treatment strategies for the subtypes are also different, as are their prognoses. An understanding of the different types of fungal sinusitis and knowledge of their particular radiologic features allow the radiologist to play a crucial role in alerting the clinician to use appropriate diagnostic techniques for confirmation. Prompt diagnosis and initiation of appropriate therapy are essential to avoid a protracted or fatal outcome.

© RSNA, 2007