 Good morning all of you. My name is Dr. Kunal Givala, EG3rd, Department of Radio Diagnosis, Saraswati Institute of Medical Science, HAPU, UP. My paper presentation topic is imaging in mucormycosis, recent trains abstract background and objectives. The purpose of this study was to describe common radiographic pattern that may be useful in predictive diagnosis of rhinocerebral mucormycosis method we retrospectively evaluate the imaging and clinical data of 5 patients 3 to 70 years old with rhinocerebral mucormycosis results. All the patients present with sinusitis and ophthalmological symptoms, most of the patient had iso intense reason relative to brain on T1 weighted image. The signal intensity in T2 weighted image was more variable with only one patient showing hyper intensity. A pattern of anatomical involvement affecting the nasal cavity, mexilocyanus, orbit and ithemoidal sinus was consistently observed in all 5 patients of a serious demonstration of mortality rate 60%. Conclusion, progressive and rapid involvement of the cavernous sinus, vascular structure and intracranial content is a visual evolution of rhinocerebral mucormycosis. In contents of the immunosuppression, a pattern of nasal cavity, mexilocyanus, ithemoidal cell and orbital inflammatory lesions so prompt the diagnosis of mucormycosis. Vascular magnetic resonance imaging show the anatomical involvement helping in surgery planning. However, the prognosis is grave despite radical surgery and antifungals, give a rhinocerebral mucormycosis imaging and radionurology. Introduction, mucormycosis is acute, fulminant and often lethal opportunity infection typically affecting the diabetic and immunocompromised patient caused by the member of the mucerosil family including epsidium, nuker and rhizoplasm. Clinical presentation is non-specific including headache, low-grade fever, facial swelling and orbit and perinazole sinus syndrome. When limited involvement of the perinazole sinus is present, survival rate are between 50 and 80%. However, when the brain invasion has occurred, mortality is greater than 80%. Because of this lethal nature, it must be recognized early and treated aggressively. We evaluate the imaging and clinical data of 4 male and 1 female, 3 to 70 years old with mucormycosis of the craniofacial area. 2 were diabetic and 4 had hematological condition and the concomitant immunocompromised state. All patients had MR imaging with 1.5 tesla system, both T1 and T2-weighted were obtained as well as T1-weighted image after IV injection of gendopentate. 4 patients had CT scan available for review. These were evaluated for density, signal intensity and contrast enhancement characteristics. The CT density was evaluated in non-enhanced image and compared with the muscles. The MR signal intensity was compared with grey matter on T1 and T2-weighted image. Gendolium enhancement was graded on scale for non-to-mark. Clinical information about presentation, management and evolution of the disease was obtained from medical history in all cases. All the patients present with sinusitis have ophthalmological symptoms. 3 patients had clinical symptoms of cavernous sinus involvement, including diplopia, ophthalmoplasia, facial and plenumness. CT findings of the 4 patients who had CT scan available for review. 3 had isodense to muscles, lesion with bone destruction. 1 patient had hypotense lesion relative to muscles in non-inclusive portion, 2nd to obstructive changes. MRI image most of the patients had iso-intense lesion relative to brain in T1-weighted image. The signal intensity in T2-weighted image was more variable with only one patient showing hyperintensity. The rest of the lesion were either hyperintensity or iso-intensive long retensional enhancement pattern. One patient did not have enhancement of his inflammatory process after the administration of gendolism. 2 patients had variable enhancement with mixed non-enhancing and marked enhancement portion of their inflammatory lesion. 1 patient had mild enhancement and remaining patients had no enhancement at all. Dural enhancement was observed in 2 patients and mixed leptomaninjel and hechimaninjel enhancement was present in another patient. Clinical evolution, orbital extraction, ithemaedectomy, medical maxillectomy and debriement of the nasal mold for performing all patients. More extensive debriement of the necrotic ithemaedectomy was performed as requiring each particular case according to surgical finding. All patient received amphotericin B locally and parentally. 2 patients recovered while 3 patients expired. This person, mucormycosis, invoked the wall of the blood vessels resulting in vascular occlusion, thrombosis, infarction, as well as the dissemination to the central nervous system from primary focus. Spread to brain may occur via orbital vessels or via cribriform grid. Generally, the present in system was low grade fever, sinusitis, facial swelling, orbital apex syndrome, blood visions. Early visual loss would favor the diagnosis of rhinocerebral mucormycosis over bacterial cavernous sinus thrombosis in which blindness is a much later findings. We found that the MRI signal intensity of mucormycosis lesion trained to be iso-intents or hyper-intents in all signal. After the administration of gendolinium, the lesion had variable enhancement pattern ranging from homogeneous to heterogeneous or non-enhancing at all. We think that the contrast enhanced T1 weighted image are helpful in eliminating the intracanial spade when the meningeal enhancement is present as well as identifying invention of the cavernous portion of internal carotid artery by the disease. This had been previously described by Muhindra and associated with the show that the MRI can defect cavernous sinus invention in the vascular complications such as ischemia. This is the image coronal image of CT at level of nexillary sinus nasal cavity. Large isodense mass lesion in right maxillary sinus extending into nasal cavity and ipsilateral orbit with bone destruction. Post-contrast coronal image showing mucosal thickening of right maxillary entrum with large isodense non-enhancing mass lesion involving ithemoidal air cells. Conclusion, progressive and rapid involvement of cavernous sinus vascular structure and intracanial content is usual evaluation of rhinocellular mucormycosis. Multi-modality image is helpful in promoting the early diagnosis when a pattern of nasal cavity, maxillary sinus, ithemoidal air cell, orbital, inflammatory process is present. Especially when the ISO or hypo intense reason are observed, multi-planar MRI show anatomical involvement which help in surgery planning however the prognosis is grave, despite radical surgery and antifungals. This is my reference. Thank you.