Diagnostic accuracy of CT scan in diagnosing paranasal fungal infection

Objective: To assess the diagnostic accuracy of CT scan in detecting paranasal sinus fungal infections. Study Design: Cross-sectional, observational study. Place and Duration of Study: Department of Radiology, Ziauddin University Hospital, Karachi, from April to September 2014. Methodology: Patients with clinical suspicion of fungal sinusitis were included in this study. Patients with already diagnosed or history of recurrent fungal infections were excluded. All these patients underwent CT scan examination of paranasal sinuses. Findings were recorded. Final diagnosis was based on smear analysis for fungal culture. Accuracy analysis was conducted for CT diagnosis using smear analysis as the gold standard. Kappa analysis was conducted to determine agreement. Results: Out of the 120 patients, 71 (59%) were male. The sensitivity, specificity, positive predictive value and negative predictive value of CT were 96.19%, 93.33%, 99.01%, 77.77%, respectively. The diagnostic accuracy was 95.83%. Kappa statistics showed 82% agreement beyond chance. Conclusion: CT scan is highly accurate in diagnosing and characterizing fungal infection of paranasal sinuses. It also determines the extent of disease which eventually aids in deciding the surgical approach to be used.