CC BY-NC-ND 4.0 · Ann Natl Acad Med Sci 2022; 58(04): 204-209
DOI: 10.1055/s-0042-1757740
Original Article

Comparison of MRI Findings in Diabetic and Nondiabetic Patients with Rhino-Orbito-Cerebral Mucormycosis

Alka Agrawal
1   Department of Radiodiagnosis, M.G.M. Medical College and M.Y. Hospital, Indore, Madhya Pradesh, India
Neetu Kori
2   Department of Ophthalmology, M.G.M. Medical College and M.Y. Hospital, Indore, Madhya Pradesh, India
Gulshan Madhpuriya
1   Department of Radiodiagnosis, M.G.M. Medical College and M.Y. Hospital, Indore, Madhya Pradesh, India
Prakhar Nigam
1   Department of Radiodiagnosis, M.G.M. Medical College and M.Y. Hospital, Indore, Madhya Pradesh, India
Simran Agrawal
3   Dr. D. Y. Patil Medical College, Kolhapur, Maharashtra, India
› Author Affiliations


Objective Rhino-orbito-cerebral mucormycosis (ROCM) has emerged as a key concern during the period of coronavirus disease 2019 (COVID-19) pandemic. Diabetes mellitus is a known risk factor for invasive fungal infection. The aim of this article was to study and compare the radiological features of COVID-19-associated ROCM between diabetic and nondiabetic patients using magnetic resonance imaging.

Materials and Methods A retrospective observational study comprising 78 diabetics and 40 nondiabetics who developed ROCM after COVID-19 was conducted. The imaging data of both groups were analyzed, findings tabulated and compared using statistical methods.

Results Maxillary and ethmoid sinuses were commonly involved in both groups. Periantral fat and orbits were the most common sites of disease extension. The spread of infection to periantral soft tissue was significantly higher in diabetics (p = 0.049). Diabetics were more likely to have bone, orbit, and brain involvement than nondiabetics, although the difference was not statistically significant. Diabetic patients were the only ones to experience complications such as fungal abscess and cavernous sinus and internal carotid artery involvement. However, a considerable number of nondiabetic patients (22.5%) also had an intracranial extension of disease.

Conclusion The radiological appearances and common sites of invasion in ROCM are similar in diabetic and nondiabetic patients. The extensive spread of infection to extra-sinus regions can occur in nondiabetic patients with COVID-19 but is less frequent compared with diabetics.

Author Contributions

A.A. contributed to conceptualization, supervision, project administration, methodology, data interpretation, review, and editing. N.K. was involved in supervision, project administration, methodology, review, and editing. G.M. contributed to draft preparation, methodology, data collection, and validation. P.N. was involved in preparation, data collection, analysis, and interpretation. S.A. was involved in data curation, analysis, and editing. All authors read and approved the final manuscript.

Ethical Approval

The study was approved by the ethics and scientific review committee of M.G.M. Medical College, Indore, Madhya Pradesh, India (approval number: IRB-22/01).

Publication History

Article published online:
02 December 2022

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