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MRI Evaluation of Covid 19 Associated Rhinoorbital Cerebral Mucormycosis
Dr. B. Lavanya Reddy, Dr. S Venkateswar Rao
DOI : 10.5281/zenodo.10633318
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Background and Objective: Parallel opportunistic infections have been identified as an additional illness spectrum since the COVID-19 pandemic began. One of these opportunistic diseases that needs attention is mucormycosis, which has seen a sharp rise in cases and rapid dissemination when compared to the pre- COVID-19 era. Following COVID-19, there have been instances of immune suppression. in addition to the presence of comorbid illnesses, which raises the possibility that mucormycosis will be deadly. Early detection and prompt diagnosis can save lives. Magnetic resonance imaging (MRI) imaging is the cornerstone of care for individuals with ROCM. The use of MRI imaging in ROCM was reviewed in this review, with particular attention paid to the optimal MRI protocol in a ROCM case, the routes by which infection spreads, the conventional diagnostic features, MRI for disease staging, MRI for prognostication, MRI for follow-up, and imaging characteristics of common differentials in ROCM.

Materials and Methods: This hospital-based prospective study was conducted on 20 people who tested positive for COVID-19 RTPCR over the course of six months, from March 2021 to August 2021, at the Department of Radiodiagnosis, Alluri Sitarama Raju Academy of Medical Sciences, Eluru. Patients had PNS, orbits, and brain MRIs, which were then analyzed. The statistical analysis employed descriptive statistics.

Image reconstruction: Volume rendering approaches for all axial, coronal, and sagittal reformats have been applied. For vascular assessment, projection images with the maximum and average intensities are used. As noted, clinical and radiological follow-up was done on the cases.

Results: 20 patients were discovered to have rhino orbital cerebral mucor mycosis out of 50 COVID 19 RTPCR positive cases; follow-up biopsies confirmed this diagnosis. Out of 20 individuals with mucor, 11 patients had involvement in the nasal cavity and paranasal sinuses, 6 patients had orbital involvement, and 4 patients had central nervous system involvement.

Conclusion: Imaging is essential for guiding surgical treatments even before clinical symptoms appear and for assessing the severity of the disease, which facilitates a timely diagnosis. When mucor spreads into the orbits and neck regions early in the disease, fat stranding may be the only imaging indicator of extra-sinus dissemination. Therefore, it is critical to thoroughly assess fat-suppressed sequences on MRI when making a diagnosis.MRI is used as a screening method to assess mucormycosis even in the absence of clinical symptoms. Therefore, MRI is essential for determining the severity, stage, and prognosis of a disease, information that is useful for therapy planning.

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