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Kanduri Sreshta1, Tarjani Vivek Dave2, Dandu Ravi Varma1
1Department of Neuroradiology, Citi Neuro Centre, Hyderabad, Telangana, India.
Abstract:
Coronavirus disease-associated mucormycosis (CAM) is an established clinical entity in India. In the past 4 months, there has been a sharp upsurge in the number of CAM cases in most parts of the country. Early diagnosis can be lifesaving. Magnetic resonance imaging (MRI) imaging remains the corner stone of management in patients with ROCM. This review discussed the utility of MRI imaging in ROCM with an emphasis on the ideal MRI protocol in a suspected case of ROCM, the pathways of spread of infection, the classic diagnostic features, MRI for staging of the disease, MRI for prognostication, MRI for follow up, and imaging features of common differentials in ROCM. The pit falls of MRI imaging and a comparison of CT and MRI imaging in ROCM are discussed. The clinical interpretation of areas of contrast uptake and those of necrosis and its relevance to treatment are discussed. This review aims to familiarize every member of the multidisciplinary team involved in managing these patients to be able to interpret the findings on MRI in ROCM.
Insights
An increase in Coronavirus disease-associated mucormycosis (CAM) cases necessitates early diagnosis. Magnetic resonance imaging (MRI) is crucial for diagnosing and managing ROCM, guiding treatment and prognosis.
Area of Science:
- Radiology
- Infectious Diseases
- Ophthalmology
Background:
- Coronavirus disease-associated mucormycosis (CAM) is a significant clinical concern in India.
- A recent surge in CAM cases highlights the need for timely diagnosis and effective management strategies.
Purpose of the Study:
- To review the utility of Magnetic Resonance Imaging (MRI) in managing Rhino-Orbito-Cerebral Mucormycosis (ROCM).
- To provide guidance on ideal MRI protocols, interpretation of imaging findings, and differential diagnoses for ROCM.
Main Methods:
- Comprehensive literature review focusing on MRI applications in ROCM.
- Discussion of MRI protocols, pathways of infection spread, diagnostic features, staging, prognostication, and follow-up.
- Comparison of CT and MRI imaging modalities for ROCM.
Main Results:
- MRI is a cornerstone for ROCM management, offering detailed insights into disease extent and complications.
- Specific MRI features aid in early diagnosis, staging, and predicting patient outcomes.
- Understanding contrast enhancement and necrosis patterns on MRI is vital for treatment decisions.
Conclusions:
- This review familiarizes multidisciplinary teams with MRI interpretation for effective ROCM patient management.
- Optimized MRI protocols and accurate interpretation are essential for improving patient outcomes in ROCM.
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