Original Articles
Spectrum of MR Imaging Features of Rhino-Orbito- Cerebral Mucormycosis in COVID-19 Patients in Tertiary Care Hospital | |
Anju Yadav, Viney Mohan, Smily Garg, Surender Bana, Jyotsna Sen | |
Background: Mucormycosis is amongst the most lethal form of zygomycosis occurring in post covid – 19 patients. The disease is seen almost exclusively in immunocompromised patients since normal phagocytic activity in immunocompetent hosts provides an adequate barrier against infection. Several cases of mucormycosis in people with COVID-19 have been reported world – wide, in particular from India. Rhino-orbito-cerebral mucormycosis is a life-threatening infection. The objective of this study was to study the radiological features of Rhino-Orbito-Cerebral Mucormycosis in Contrast Enhanced MRI Brain-Orbit-PNS in COVID-19 patients admitted in tertiary care hospital. Materials and Methods: The case records of patients with biopsy/culture proven invasive mucormycosis were reviewed. Contrast enhanced Magnetic Resonance Imaging (MRI) images were retrieved from the Picture Archiving and Communication System (PACS) and analyzed. Results: Contrast enhanced MR imaging of 64 patients were reviewed. In the majority of patients (47, 73.4%) pansinusitis was present. The combination of maxillary, ethmoid and sphenoid (10, 15.6%) was the second most common seen. Bilateral sinus involvement was more common (79.1%) than unilateral sinus involvement (20.9%). Bony erosions were most common seen in 37 cases (57.8%) followed by black turbinate sign which was seen in 28(43.7%) of cases. Loss of periantral fat is earliest sign of soft tissue involvement & was seen in maximum number of cases (75%). In our study extension to the orbit (48, 75%) and face (35, 55%) preceded involvement of the deep skull base (9, 14%) and brain parenchymal complications (17,26%). MRI showed T1 isointense to hyperintense, T2 isointense to mildly hypointense soft tissue thickening and heterogeneous post contrast enhancement as the main finding. MRI is quite helpful to assess early bony involvement, ocular & cerebral involvement. Conclusion: MRI shows a spectrum of findings in rhino-orbito-cerebral mucormycosis. Imaging plays a major role in assessing the extent of involvement and complications. Cerebral involvement was more common in uncontrolled diabetic patients. |
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