EURORAD ESR

Case 15264

Optic Nerve Restricted Diffusion in Rhinocerebral Mucormicosys

Author(s)
Carolina Figueira1; João Figueira2; Teresa Garcia1

1 Serviço de Imagem Médica - Neurorradiologia
2 Serviço de Oftalmologia
Centro Hospitalar e Universitário de Coimbra (CHUC); Coimbra 3030 335, Portugal; Email:carolinachaves@sapo.pt
 
Patient
male, 54 year(s)
 
 
  • Figure 1
    Axial T1 post-gadolinium with fat saturation

    MRI demonstrates inflammatory changes in the right etmoid and maxilary sinus, with enhacement of the orbital fat and retromaxilary fossa structures on postcontrast T1 images.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Contrast agent-intravenous; Special Focus: Infection;
     
     
  • Figure 2
    Coronal T1 post-gadolinium with fat saturation

    MRI demonstrates inflammatory changes in the right etmoid and maxilary sinus, with enhacement of the orbital fat and retromaxilary fossa structures on postcontrast T1 images.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Contrast agent-intravenous; Special Focus: Infection;
     
     
  • Figure 3
    DW-MR sequence

    The right optic nerve (white arrow) show hyperintense signal on DWI.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Computer Applications-Detection, diagnosis; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 4
    ADC map

    The right optic nerve (white arrow) show hypointense signal on the ADC map, compatible with restriction diffusion.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Computer Applications-Detection, diagnosis; Special Focus: Ischaemia / Infarction;
     
     
  • Figure 5
    Pathology

    Grocott-Gomori methenamine-silver stain (200x) highlighting fungal elements.

     
    Area of Interest: Head and neck; Imaging Technique: Image manipulation / Reconstruction; Procedure: Biopsy; Special Focus: Infection;
     
     
MRI demonstrates inflammatory changes in the right etmoid and maxilary sinus, with enhacement of the orbital fat and retromaxilary fossa structures on postcontrast T1 images.
 
MRI demonstrates inflammatory changes in the right etmoid and maxilary sinus, with enhacement of the orbital fat and retromaxilary fossa structures on postcontrast T1 images.
 
The right optic nerve (white arrow) show hyperintense signal on DWI.
 
The right optic nerve (white arrow) show hypointense signal on the ADC map, compatible with restriction diffusion.
 
Grocott-Gomori methenamine-silver stain (200x) highlighting fungal elements.
 
 
 
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