Mucormycosis radiological evidence in ct and mri

Mucor

1. MAGNETIC RESONANCE IMAGING
FEATURES OF RHINO ORBITAL
MUCORMYCOSIS
PRESENTING AUTHOR - DR G SRAVAN KUMAR

2. INTRODUCTION

●Mucormycosis is an acute, fulminant and often
opportunistic infection, typically affecting diabetic or
immunocompromised patients.

●After infection of the nasal cavity
and PNS, the fungi cause a
necrotizing vasculitis that extends
rapidly into deep face, orbits,
cranial cavity and brain.

3. ●We retrospectively reviewed the MRI findings in a
series of 40 patients with the rhino orbital mucormycosis
to establish a common radiographic pattern that may be
useful in predicting the diagnosis of this infection.

4. AIM
●To study the MRI features of rhino-orbital mucormycosis.

MATERIALS AND METHODS
●Type of study - Retrospective study
●Sample size - 40
●Duration of study -6 months ( Mar 2021 to Aug 2021)
●Investigations - MRI PNS and ORBITS (1.5Tesla)
●MRI- T1 weighted, T2 weighted and post contrast T1 with
coronal, axial and sagittal cuts.

5. INCLUSION CRITERIA
●All patients presenting to the ENT department with
histologically proven rhino orbital mucormycosis.
EXCLUSION CRITERIA
●Cerebral involvement
●Where contrast cannot be used

6. RESULTS

8. MRI FEATURE N (%)
1.T1 W signal
- Hypointense

35 (87.5%)
2. T2 W signal
- Isointense/hypointense
- Heterogenous
- Hyperintense

16 (40%)
13 (32.5%)
11 (27.5%)
3. Enhancement pattern ( contrast)
- Intense homogenous
- Heterogenous
- Central non enhancemnt with
rim enhancement

10 (25%)
17 (42.5%)
13 (32.5%)

11. DISCUSSION
●Our study included 40 patients of proven
mucormycosis.
●All the patients underwent MRI imaging and the
findings were documented.
●Patients initially present with sinonasal involvement
which later spread to the orbits, face, pterygopalatine
fossa, hard palate, maxillary alveolus, zygomatic
process.

12. ●Among all patterns of MRI, T1 hypointense and T2
hypointense appearance was seen in more cases. It
may be due to presence of iron and manganese in
fungal elements.
●Both T2 W and contrast findings are variable and are
not reliable markers.
●Imaging like MRI show variable and sometimes non
specific features like mucosal thickening in early stages
of disease which may delay diagnosis.

13. ●In this study, imaging showed different patterns of
enhancements and signal intensities with extra sinus
involvement.
●So imaging alone cannot be useful in diagnosing fungal
disease which requires clinical and pathological
correlation.
●But MRI can be useful to know extrasinus involvement,
extent of disease, complications and route map for
surgery.
CONCLUSION

14. REFERENCES
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SK. Magnetic resonance imaging in rhino-orbital-cerebral
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