IMAGING OF RHINO-ORBITO-CEREBRAL MUCORMYCOSIS A PROSPECTIVE OBSERVATIONAL STUDY IN THE SETTING OF COVID 19 PANDEMIC IN A TERTIARYCARE CENTRE IN AP, INDIA

Abstract

Background: Rhino-orbito-cerebral mucormycosis (ROCM) is a potentially fatal fungal infection that commonly affects diabetic and other immunocompromised patients. Necrotizing and angioinvasive features of this class of pathogenic fungi facilitate spread from sinuses into orbit and brain with devastating consequences. Early diagnosis and timely intervention is key to successful treatment Objective: To interpret the Imaging ndings of all patients presented with ROCM at various stages on CT and MRI . Materials and methods: This prospective observational descriptive study was conducted in the Department of Radiodiagnosis, Andhra Medical College, King George Hospital, Visakhapatnam, India from April 2021 to August 2021 for 5 months. Reviewed 100 patients of adult age group with strong clinical complaints suggestive of ROCM predominantly by MRI and also by CT Results: We presented 100 cases of ROCM to emphasize effectiveness of magnetic resonance imaging (MRI) in diagnosis of this potentially fatal form of mucormycosis.. CT and MR imaging of 100 patients showed predominantly pan-sinus involvement (67%). Extension to the orbit and face (66%) preceded involvement of the deep skull base (62%) and brain (40%). Bone erosion was seen less often (40%), with rest (60%) of the patients showing extra sinus extension across grossly intact appearing bones on imaging. Conclusion: CT and MRI show a spectrum of ndings in rhinocerebral mucormycosis. Imaging plays a major role in assessing the extent of involvement and complications. DWI may add specicity to the diagnosis by showing restricted diffusion in the path of fungal invasion. Thus Magnetic resonance imaging is highly useful imaging modality for the diagnosis of ROCM and for staging of the disease.