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Cervicofacial tissue infarction in patients with acute invasive fungal sinusitis: prevalence and characteristic MR imaging findings

  • Head and Neck Radiology
  • Published:
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Abstract

Introduction

Tissue infarction is known as one of the characteristic features of invasive fungal sinusitis (IFS). The purpose of this study was to investigate the prevalence and characteristic MR imaging findings of cervicofacial tissue infarction (CFTI) associated with acute IFS.

Methods

We retrospectively reviewed MR images in 23 patients with histologically or microbiologically proven acute IFS. CFTI was defined as an area of lack of enhancement in and around the sinonasal tract on contrast-enhanced T1-weighted images. We divided CFTI into two groups, i.e., intrasinonasal and extrasinonasal. Particular attention was paid to the location of extrasinonasal CFTI and the signal intensity of CFTI on T1- and T2-weighted images. The presence of bone destruction on CT scans was also recorded.

Results

CFTI was found in 17 (74 %) of 23 patients. All of these 17 patients had intrasinonasal CFTI, and 13 patients also had extrasinonasal CFTI. All 13 patients with extrasinonasal CFTI died of disease directly related to IFS. Various locations were involved in the 13 patients with extrasinonasal CFTI, including the orbit (n = 8), infratemporal fossa (n = 7), intracranial cavity (n = 3), and oral cavity and/or facial soft tissue (n = 4). Various signal intensities were noted at the area of CFTI on T1- and T2-weighted images. Bone destruction was found on CT scans in only 3 of 17 patients with CFTI.

Conclusion

CFTI with preservation of the bony wall of the involved sinonasal tract may be a characteristic MR imaging finding of acute IFS. The mortality is very high once the lesion extends beyond the sinonasal tract.

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Korea

    Jungmin Seo, Hyung-Jin Kim, Eunhee Kim, Hanbee Lee, Jin Wook Choi, Ji Hoon Cha, Hye Jung Kim & Sung Tae Kim

  2. Department of Otolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Seung-Kyu Chung

  3. Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

    Eunhee Kim

  4. Department of Radiology, Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Korea

    Hanbee Lee

  5. Department of Radiology, Ajou University School of Medicine, Suwon, Korea

    Jin Wook Choi

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  1. Jungmin Seo
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Correspondence to Hyung-Jin Kim.

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Hyung-Jin Kim and Seung-Kyu Chung contributed equally to this work.

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Seo, J., Kim, HJ., Chung, SK. et al. Cervicofacial tissue infarction in patients with acute invasive fungal sinusitis: prevalence and characteristic MR imaging findings. Neuroradiology 55, 467–473 (2013). https://doi.org/10.1007/s00234-013-1147-8

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  • DOI: https://doi.org/10.1007/s00234-013-1147-8

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