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Split-bolus, single-phase contrast enhanced CT: a one-stop shop for invasive fungal sinusitis
Ashu Seith Bhalla1, Smita Manchanda2, Kavirajan Kabilan1
1Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
Abstract:
Contrast-enhanced magnetic resonance imaging is considered the imaging modality of choice for invasive fungal sinusitis (IFS); however, it is not feasible to perform emergency CEMRI especially in the setting of COVID-19. The CECT protocol for evaluation of suspected IFS can be modified by using split-bolus, single-phase CT as it provides an optimal soft tissue demonstration of sinonasal disease; extrasinus spread to orbit, and intracranial involvement along with simultaneous opacification of the internal carotid artery and cavernous sinus. The extent of bone erosion can also be well delineated on the multiplanar reconstructions (MPRs) in the bone window. Further a structured reporting format can help provide optimal surgical guidance in cases of IFS.
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