Role of Radiology in Mucormycosis: Recent Update

Abstract

The purpose of this study was to describe common radiographic patterns that may be useful in predicting the diagnosisof rhinocerebral mucormycosis. Methods: We retrospectively evaluated the imaging and clinical data of four males andone female, 3 to 72 years old, with rhinocerebral mucormycosis. Results: All the patients presented with sinusitis andophthalmological symptoms. Most of the patients (80%) had isointense lesions relative to brain in T1-weighted images.The signal intensity in T2-weighted images was more variable, with only one (20%) patient showing hyperintensity. Apattern of anatomic involvement affecting the nasal cavity, maxillary sinus, orbit, and ethmoid cells was consistentlyobserved in all five patients (100%). Our series demonstrated a mortality rate of 60%. Conclusion: Progressive and rapidinvolvement of the cavernous sinus, vascular structures and intracranial contents is the usual evolution of rhinocerebralmucormycosis. In the context of immunosupression, a pattern of nasal cavity, maxillary sinus, ethmoid cells, and orbitinflammatory lesions should prompt the diagnosis of mucormycosis. Multiplanar magnetic resonance imaging showsanatomic involvement, helping in surgery planning. However, the prognosis is grave despite radical surgery andantifungals.