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Utilizing CT soft-tissue markers as a screening tool for acute invasive fungal sinusitis.
John, Deepa Susan; Shyam, Karthik; Andrew, Dhilip; Cicilet, Soumya; Deepalam, Saikanth Reddy.
  • John DS; Department of Radiology, St. John's Medical College Hospital, Bangalore, Karnataka, India.
  • Shyam K; Department of Radiology, St. John's Medical College Hospital, Bangalore, Karnataka, India.
  • Andrew D; Department of Radiology, St. John's Medical College Hospital, Bangalore, Karnataka, India.
  • Cicilet S; Department of Radiology, St. John's Medical College Hospital, Bangalore, Karnataka, India.
  • Deepalam SR; Department of Radiology, St. John's Medical College Hospital, Bangalore, Karnataka, India.
Br J Radiol ; 95(1132): 20210749, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1594506
ABSTRACT

OBJECTIVES:

Acute invasive fungal sinusitis (AIFS) is a rapidly progressive disease, whose delayed identification results in poor outcomes, especially in immunocompromised individuals. A surge in of AIFS in the wake of the COVID-19 pandemic has lent additional morbidity and mortality to an already precarious clinical scenario. Early detection of AIFS in individuals who are symptomatic/ at risk can allow early therapy, enabling better patient outcomes. Our study aims to determine optimal soft-tissue markers on CT for the early detection of AIFS.

METHODS:

In this case-control study, 142 patients with equal distribution of subjects were chosen based on histopathological diagnosis of AIFS; and their non-contrast CT scans were retrospectively assessed to determine the diagnostic utility of specific soft-tissue markers that would enable diagnosis of AIFS.

RESULTS:

A total of nine markers with adequate sensitivity and specificity were identified, including pterygopalatine and sphenopalatine fossae, inferior orbital fissure and nasolacrimal duct involvement, premaxillary thickening, retro-antral and orbital stranding, and infratemporal muscle oedema. It was determined that the combined occurrence of any three out of nine markers was 91.5% sensitive and 95.9% specific for diagnosis of AIFS (p < 0.005).

CONCLUSION:

Early, accurate detection of AIFS in predisposed individuals is possible with identification of soft-tissue markers on NECT, enabling early intervention. ADVANCES IN KNOWLEDGE Being the aggressive disease that it is, AIFS may be managed early if the index of suspicion is held high via CT imaging; which our diagnostic checklist aims at enabling.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Sinusitis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Limits: Humans Language: English Journal: Br J Radiol Year: 2022 Document Type: Article Affiliation country: Bjr.20210749

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Sinusitis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Limits: Humans Language: English Journal: Br J Radiol Year: 2022 Document Type: Article Affiliation country: Bjr.20210749