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新型冠状病毒肺炎相关鼻-鼻窦毛霉菌病的磁共振成像

Magnetic Resonance Imaging in COVID-19 Associated Rhino-Sinusal Mucormycosis.

作者信息

Ciurea Mircea Viorel, Jeican Ionuț Isaia, Balica Nicolae, Vrânceanu Daniela, Albu Silviu

机构信息

Discipline of Oro-Maxillo-Facial Surgery and Implantology, Faculty of Dental Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400029, Cluj-Napoca, Romania.

Department of Anatomy and Embryology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.

出版信息

Curr Health Sci J. 2024 Jan-Mar;50(1):74-80. doi: 10.12865/CHSJ.50.01.10. Epub 2024 Mar 31.

Abstract

Rhino-sinusal mucormycosis is an acute invasive fungal infection rarely encountered in the clinical setting, occurring in severe immunosuppressed patients. However, in patients suffering from COVID-19 disease a dramatic increase in the incidence of mucormycosis has been recorded. The aim of the study is to discuss the MRI findings of patients with COVID-19 associated mucormycosis. This is a retrospective review of 10 hospitalized and operated patients in three Otolaryngologic Departments between the 1st of February 2021 and the 30th of October 2021. All patients presented nasal mucormycosis, histologically verified along with documented SARS-CoV-2 positive RT-PCR test. The sinus involvement, extra sinus spread and peri-sinus invasion were documented in all patients. The correlation between MRI and intra-operative findings was also assessed. The black turbinate sign and peri-antral soft tissue infiltration are early MRI signs characteristic of mucormycosis. Moreoever, MRI has a significantly high positive predictive value for intra-operative findings in COVID-19 associated mucormycosis.

摘要

鼻-鼻窦毛霉菌病是一种急性侵袭性真菌感染,在临床环境中很少见,发生于严重免疫抑制患者。然而,在新冠肺炎患者中,毛霉菌病的发病率显著增加。本研究的目的是探讨新冠肺炎相关毛霉菌病患者的MRI表现。这是一项对2021年2月1日至2021年10月30日期间在三个耳鼻喉科住院并接受手术的10例患者的回顾性研究。所有患者均表现为鼻腔毛霉菌病,经组织学证实,并记录有SARS-CoV-2阳性RT-PCR检测结果。记录了所有患者的鼻窦受累情况、鼻窦外扩散和鼻窦周围侵犯情况。还评估了MRI与术中发现之间的相关性。黑鼻甲征和窦周软组织浸润是毛霉菌病的早期MRI特征性表现。此外,MRI对新冠肺炎相关毛霉菌病的术中发现具有显著高的阳性预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e0e/11151946/67ff16bd7702/CHSJ-50-01-74-fig1.jpg

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