Diagnostic Accuracy of C.T Scan in Fungal Sinusitis, Diagnosis and Extent

Objective: To assess the diagnostic accuracy of computed tomography in evaluation of diagnosis and intra cranial / intra orbital extent of fungal sinusitis, histopathology kept as reference value. Study Design: Descriptive, cross - sectional study Place and Duration: This study was carried out at Radiology and Otorhinolaryngology department of Civil Hospital and Dow Medical College Karachi, from January 2015 to December 2015. Materials and Methods: Out of 427 patients of nasal obstruction only 98 cases were included, whose diagnosis of nasal polyposis was confirmed on clinical examination. All these patients referred from ENT Ward to the Radiology Department at Civil Hospital Karachi for C.T scan to know the extent of the lesion. Patients between 20 - 65 years of either gender, clinically diagnosed cases of sinonasalpolyposis and recurrent / chronic rhinosinusitis were included in the study. Exclusion criteria were cases of acute rhino sinusitis and postsurgical cases. All CTs were reported the expert and proficient radiologist of the department having more than 05 years of experience CT reporting. CT results assess for the presence of high density areas in the plain study, of the sinusthinning /expansion and bone erosion noted and extent of the disease noted that is the presence or absence of intracranial and intra orbital. Results: Among all 98 numbers of patients in this study rate of complications are highest at the age group of 20-30 years i.e. 28.6%. No significant gender preponderance was noted statistically. 41 (41.8 %) of the patients had intra cranial extension, 47 (47.9%) had intra orbital extension and 59 (60.2%) had bony erosions The sensitivity of CT scan by taking histopathology findings as gold standard was 89.3% and specificity 86.9%. The positive predictive value of CT scan was 95.7% and negative predictive value was 71.4% and Diagnostic Accuracy was 88.7% Conclusion: There is considerably high sensitivity rate and reasonable specificity of CT imaging in the diagnosis of fungal sinusitis and detection of bone erosions, intracranial / intra orbital extension of the disease which is confirmed by histopathology results.