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Post COVID-19 Head and Neck Mucormycosis: MR Imaging Spectrum and Staging.
Metwally, Maha Ibrahim; Mobashir, Mohamed; Sweed, Ahmed Hassan; Mahmoud, Sara Mohamed; Hassan, Aya Gamal; ElKashishy, Kamal; Eesa, Mohamed; Elnashar, Ismail; Elmalt, Ashraf; Elsayed, Ahmed Ibrahim; Idris, Shaimaa Khaled; Elshetry, Al Shaimaa Fathi.
  • Metwally MI; Lecturer of of Radio-diagnosis, Faculty of Human Medicine, Zagazig University, Egypt. Electronic address: aleenys009@gmail.com.
  • Mobashir M; Professor of Otorhinolaryngology-Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Egypt.
  • Sweed AH; Lecturer of Otorhinolaryngology-Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Egypt.
  • Mahmoud SM; Assistant lecturer of Radio-diagnosis, Faculty of Human Medicine, Zagazig University, Egypt.
  • Hassan AG; Assistant lecturer of Radio-diagnosis, Faculty of Human Medicine, Zagazig University, Egypt.
  • ElKashishy K; Professor of Pathology, Faculty of Human Medicine, Zagazig University, Egypt.
  • Eesa M; Lecturer of Otorhinolaryngology-Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Egypt.
  • Elnashar I; Professor of Otorhinolaryngology-Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Egypt.
  • Elmalt A; Professor of Otorhinolaryngology-Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Egypt.
  • Elsayed AI; Professor of Otorhinolaryngology-Head and Neck Surgery, Faculty of Human Medicine, Zagazig University, Egypt.
  • Idris SK; Assistant lecturer of Radio-diagnosis, Faculty of Human Medicine, Zagazig University, Egypt.
  • Elshetry ASF; Lecturer of of Radio-diagnosis, Faculty of Human Medicine, Zagazig University, Egypt.
Acad Radiol ; 29(5): 674-684, 2022 05.
Article in English | MEDLINE | ID: covidwho-1568451
ABSTRACT

OBJECTIVE:

To develop a systematic approach for magnetic resonance imaging (MRI) analysis, imaging spectrum, and classification system for the staging of post-COVID-19 head and neck mucormycosis.

METHOD:

The study included 63 post-COVID-19 patients with pathologically proven mucormycosis who underwent head and neck MR imaging. Three independent radiologists assessed the imaging spectrum of mucormycosis, MRI characteristics of sino-nasal mucormycosis, and extra-sinus extension, and submitted a final staging using a systematic approach and a proposed categorization system. A consensus reading was considered the reference imaging standard. The kappa statistics were used to assess the categorization system's diagnostic reliability.

RESULTS:

The overall interreader agreement of the MR staging system was very good (k-score = 0.817). MR imaging spectrum involved localized sino-nasal mucormycosis (n = 7 patients, 11.1%), sino-nasal mucormycosis with maxillo-facial soft tissue extension (n = 28 patients, 44.5 %), sino-nasal mucormycosis with maxillo-facial bony extension (n = 7 patients, 11.1%), sino-naso-orbital mucormycosis (n = 13 patients, 20.6%), and sino-nasal mucormycosis with cranium or intracranial extension (n = 8 patients, 12.7%). Extra-sinus extension to the orbit and brain did not have significant association with involvement of the posterior ethmoid/sphenoid sinuses and maxillo-facial regions (p > 0.05). MRI-based staging involved four stages stage 1 (n = 7, 11.1%); stage 2 (n = 35, 55.6%), and stage 3 (n = 13, 20.6%), and stage 4 (n = 8, 12.7%). Involvement of the bone and MR-based staging were significant predictors of patients' mortality p = 0.012 and 0.033, respectively.

CONCLUSION:

This study used a diagnostic-reliable staging method to define the imaging spectrum of post-COVID-19 head and neck mucormycosis and identify risk variables for extra-sinus extension.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Orbital Diseases / COVID-19 / Mucormycosis Type of study: Diagnostic study / Prognostic study / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Acad Radiol Journal subject: Radiology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Orbital Diseases / COVID-19 / Mucormycosis Type of study: Diagnostic study / Prognostic study / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Acad Radiol Journal subject: Radiology Year: 2022 Document Type: Article