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01-07-2018 | Head-Neck-ENT Radiology

Acute invasive fungal rhinosinusitis: MR imaging features and their impact on prognosis

Authors: Ye Ra Choi, Ji-hoon Kim, Hye Sook Min, Jae-Kyung Won, Hyun Jik Kim, Roh-Eul Yoo, Koung Mi Kang, Sun-Won Park, Tae Jin Yun, Seung Hong Choi, Chul-Ho Sohn, Jung Hyo Rhim, Soo Chin Kim, Jae Wook Ryu, Dong Gyu Na

Published in: Neuroradiology | Issue 7/2018

Abstract

Purpose

Acute invasive fungal rhinosinusitis (AIFRS) is a life-threatening disease that is difficult to diagnose. Its overall imaging features have not been evaluated and the prognostic impact is unclear. The purpose of our study was to present MR imaging features and their impact on prognosis of AIFRS.

Methods

MR images and clinical records of 23 patients with AIFRS were retrospectively evaluated to identify the imaging features and to determine the factors affecting patients’ survival. A multivariable Cox proportional hazard model was used to estimate the hazard ratio of the prognostic factors, and Kaplan-Meier survival curves were compared by using a log-rank test.

Results

All cases showed extra-sinonasal involvement and the orbit was the most common (65.2%, 15/23) location. The lesion enhancement pattern was classified into lack of contrast enhancement (LoCE) (47.8%, 11/23) and homogeneous (34.8%, 8/23) and heterogeneous (17.4%, 4/23) enhancement. Although LoCE showed variable signal intensity (SI), homogeneously or heterogeneously enhancing lesions showed exclusively low SI (100%, 12/12) on T2WI. Among various clinical and imaging factors, LoCE was correlated with coagulation necrosis, probably provoked by numerous fungal hyphae, and was found to be a sole independent prognostic factor for disease-specific mortality (hazard ratio = 16.819; 95% CI, 1.646–171.841, p = 0.017). In addition, patients with LoCE showed worse survival than patients without LoCE (p = 0.008).

Conclusion

AIFRS showed frequent extra-sinonasal involvement and variable MR enhancement patterns. An enhancement pattern of LoCE was seen in about half of the cases and was a unique prognostic factor among the various clinico-radiologic factors.

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Title: Acute invasive fungal rhinosinusitis: MR imaging features and their impact on prognosis
Authors: Ye Ra Choi
Ji-hoon Kim
Hye Sook Min
Jae-Kyung Won
Hyun Jik Kim
Roh-Eul Yoo
Koung Mi Kang
Sun-Won Park
Tae Jin Yun
Seung Hong Choi
Chul-Ho Sohn
Jung Hyo Rhim
Soo Chin Kim
Jae Wook Ryu
Dong Gyu Na
Publication date: 01-07-2018
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 7/2018
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-018-2034-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Acute invasive fungal rhinosinusitis: MR imaging features and their impact on prognosis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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