Magnetic Resonance Imaging Prognostic Findings for Visual and Mortality Outcomes in Acute Invasive Fungal...

Area of Science:

• Radiology
• Ophthalmology
• Infectious Diseases

Background:

• Acute invasive fungal rhinosinusitis (AIFRS) is a severe infection with significant morbidity and mortality.
• Early identification of prognostic factors is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To determine if initial, preintervention magnetic resonance imaging (MRI) findings can predict visual and mortality outcomes in patients with AIFRS.

Main Methods:

• Retrospective cohort study of 78 patients with confirmed AIFRS.
• Analysis of MRI scans and clinical records using modified Poisson regression and Cox proportional hazards models.
• Evaluation of radiologic characteristics for association with blindness and mortality.

Main Results:

• Orbital apex or cerebral artery involvement on initial MRI was associated with poor visual acuity (RR 2.0 and 1.8, respectively).
• Facial soft tissue, nasolacrimal drainage apparatus, or intracranial involvement correlated with increased mortality (HR 4.9, 5.0, and 3.5, respectively).
• Orbital soft tissue involvement was linked to decreased mortality (HR 0.3).

Conclusions:

• Initial MRI findings are prognostic for visual and mortality outcomes in AIFRS.
• Orbital apex and cerebral artery involvement predict poor visual outcomes.
• Facial soft tissue, nasolacrimal drainage, and intracranial spread indicate higher mortality risk, while orbital soft tissue involvement suggests a better prognosis.