Imaging Characteristics and Radiological Analysis of Rhinoorbital - Cerebral Mucormycosis.

Abstract

Objective: To demonstrate the usefulness of magnetic resonance imaging (MRI) in diagnosing important imaging findings in rhino-orbito-cerebral mucormycosis.

Materials and methods: This is a retrospective cross-sectional study conducted at three medical colleges over 1 month in the patients diagnosed with coronavirus disease 2019 (COVID-19) and who developed mucormycosis of the paranasal sinuses during the treatment and in the post-recovery phase.

Results: A total of 95 patients with male preponderance presented with mucormycosis. All had an association with COVID-19 virus disease. All the patients had a history of steroid use during their COVID-19 virus disease treatment. Painful proptosis was present in 42% of patients. The maxillary sinuses (97.22%) were the most commonly affected. Intraorbital extension was observed in 63% of cases, while intracranial extension was demonstrated in 10% of cases. Three patients had perineural spread, and one patient developed a mycotic aneurysm.

Conclusions: MRI plays a very crucial role in the prompt and early diagnosis of rhino-orbito-cerebral mucormycosis, as it is used to evaluate the invasion of the disease into the surrounding structures, as well as in preoperative planning for surgical debridement and to ascertain the prognosis. Diffusion-weighted imaging (DWI) adds specificity to localize the path of disease extension by showing restricted diffusion.