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MR Imaging in Covid-19-Associated Invasive Fungal Sinusitis.

Divya Pabbisetti1, Anantaram Gudipati, Subhash Kaul

  • 1Department of Radiology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India.

Neurology India
|October 21, 2024
PubMed
Summary
This summary is machine-generated.

A sharp increase in invasive fungal sinusitis, especially mucormycosis, was seen in COVID-19 survivors in India. Magnetic resonance imaging (MRI) is crucial for early diagnosis of rhino-orbito-cerebral mucormycosis (ROCM) and its complications.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • A significant rise in invasive fungal sinusitis, particularly mucormycosis, observed in India post-coronavirus disease 2019 (COVID-19).
  • Rhino-orbito-cerebral mucormycosis (ROCM) is a severe, rapidly progressing infection.
  • Early diagnosis is critical for improving patient survival and outcomes.

Purpose of the Study:

  • To analyze magnetic resonance (MR) imaging findings of invasive fungal sinusitis in post-COVID-19 patients.
  • To establish an MR imaging protocol for early diagnosis of ROCM and its complications.
  • To compare imaging features between COVID-19-associated and non-COVID-19-associated ROCM.

Main Methods:

  • Retrospective analysis of MR imaging manifestations.
  • Inclusion of 91 histopathologically confirmed cases of post-COVID-19 invasive fungal sinusitis.

Main Results:

  • Stage III disease with intracranial spread occurred in 51.6% of patients.
  • Dural involvement was the earliest sign of intracranial spread.
  • Direct parenchymal invasion into the frontal and temporal lobes was the most common pattern of cerebral involvement.
  • Common complications included cavernous sinus involvement (29.6%) and osteomyelitis (45%).

Conclusions:

  • Stage III ROCM in COVID-19 survivors is often due to direct spread from sinuses to brain lobes.
  • Cavernous sinus involvement and internal carotid artery angioinvasion were the most frequent vascular complications.