343490

Magnetic Resonance Imaging pearls in the Diagnosis of Coronavirus associated rhino-orbital-cerebral fungal infection : Retrospective Imaging Analysis of 80 Patients

Article

Last updated: 04 Jan 2025

Subjects

-

Tags

Diagnostic Radiology.
Infection and immunity.

Abstract

Background: Rhino-orbital-cerebral mucormycosis has emerged as a major opportunistic infection in patients with COVID-19 and shows tremendous increase during second wave of the COVID-19 pandemic. High clinical suspicion and prompt imaging are crucial for early diagnosis and management as it leads to pernicious morbidity /mortality result 
Objectives: This study's goal is to describe the different MRI findings of COVID-19 associated  rhino-orbital-cerebral mucormycosis (CA-ROCM) , to be familiar with the wide imaging variety which is crucial for early diagnosis and management
Patients and Methods: In this retrospective study, which included 178 patients confirmed with COVID-19 through March 2020 and February 2022.After reviewing the pateints' imaging data, only 80 patients were included. Medical records with a special emphasis on MRI were reviewed regarding the severity of sinuses and nasal cavity affection, orbital and cerebral invasion.
Results: We reported findings in 80 patients with (CA-ROCM). The study cohort had 12 patients with isolated sino-nasal involvement( stage I) , 28 patients with sino-nasal-orbital involvement ( stage II), and 40 patients with intracranial involvement (stage III).The most frequently involved sinuses were ethmoid & maxillary sinuses represented in 75 patients (93.7 %) .Black turbinate sign and non-enhancing sino-nasal mucosa were observed in 63 patients (87.7 %). Sixty two patients (77.5 %) presented with orbital extension. Thirty one (38.7 %) patients had thickening and enhancement of dura, cerebritis was reported in 24patients (30 %). Cerebral ischemic infarcts were seen in 12 (15 %) patients. Post contrast MRI results was correlated with operative data and  revealed that MRI had  higher  sensitivity and specificity in stage III disease  (100 % , 100%)   rather than stage II   (94 % , 96%) and stage I disease (85%, 89%).
Conclusions: MRI findings of CA-ROCM significantly vary from mild mucosal thickening of paranasal sinuses up to intracranial and orbital invasion. MRI with contrast can early detect subtle inflammatory changes outside the paranasal sinuses as early diagnosis of nasal/orbital/cranial invasion would reduce individuals, mortality and  morbidity rates.

DOI

10.21608/svuijm.2023.180096.1469

Keywords

MRI, COVID 19, CA-ROCM

Authors

First Name

Neveen Seif Alislam

Last Name

shaker

MiddleName

-

Affiliation

Diagnostic Radiology Department, Faculty of Medicine, Tanta University 31527, Tanta ,Egypt

Email

dr.neveenseif@hotmail.com

City

tanta

Orcid

-

First Name

Rehab Mohamed

Last Name

Elnagar

MiddleName

-

Affiliation

Diagnostic Radiology Department, Faculty of Medicine, Tanta University 31527, Tanta ,Egypt

Email

dr.rehabelnagar@yahoo.com

City

tanta

Orcid

-

First Name

Basma Samir

Last Name

Eldeeb

MiddleName

-

Affiliation

Diagnostic Radiology Department, Faculty of Medicine, Tanta University 31527, Tanta ,Egypt

Email

dr.basama.samir@gmail.com

City

tanta

Orcid

-

Volume

7

Article Issue

1

Related Issue

43681

Issue Date

2024-01-01

Receive Date

2022-12-11

Publish Date

2024-01-01

Page Start

402

Page End

418

Print ISSN

2735-427X

Online ISSN

2636-3402

Link

https://svuijm.journals.ekb.eg/article_343490.html

Detail API

https://svuijm.journals.ekb.eg/service?article_code=343490

Order

42

Type

Original research articles

Type Code

1,520

Publication Type

Journal

Publication Title

SVU-International Journal of Medical Sciences

Publication Link

https://svuijm.journals.ekb.eg/

MainTitle

Magnetic Resonance Imaging pearls in the Diagnosis of Coronavirus associated rhino-orbital-cerebral fungal infection : Retrospective Imaging Analysis of 80 Patients

Details

Type

Article

Created At

27 Dec 2024