Способ ранней визуализации COVID-19 ассоциированного тромбоза кавернозного синуса

Abstract

Purpose. Development and evaluation of the effectiveness of the most optimal method of imaging for COVID-19 associated cavernous sinus thrombosis (CST). Material and methods. The study included the results of observation of 98 patients with CST. In all cases, COVID-19 confirmed by serological test results and the presence of specific lung lesions. The description and interpretation of MRI images in special modes (T2 TSE (cut 0.6-1.6 mm) and Dark fluid T2 (cut 0.6-1.6 mm), which allow determining the presence of a thrombus, have been carried out. Results. The use of this imaging module made it possible to determine the development of thrombosis in the projection of the orbital vein before its transition to the cavernous sinus in 24 patients who underwent COVID-19 and were admitted with complaints of difficulty in nasal breathing, purulent nasal discharge and severe headache. The detection of thrombus formation at this stage and the beginning of early intensive conservative therapy made it possible to achieve a favorable clinical outcome in the patient in the form of preserving the eyeball as an organ and partially preserving its functional capacity. In other cases, the sensitivity and specificity of the proposed technique were also high and amounted to more than 90%. Conclusion. The proposed imaging method for COVID-19 associated CST is highly sensitive and allows timely diagnosis and initiation of appropriate treatment, which will lead to a more favorable outcome in patients. Key words: cavernous sinus thrombosis; COVID-19; imaging; MRI.