 Hello my name is Dr. Ayushman Virmani and I am presenting my paper on Role of CT and MRI in Rhinoorbital Cerebral Mucormycosis. The contents of today's presentation will be AIM, Introduction, Methods, Results, Discussion, Conclusion and References. The aim of our study was to describe the role of CT and MRI in patients with Rhinoorbital Cerebral Mucormycosis. Rhinoorbital Cerebral Mucormycosis is an acute, fulminant and often lethal opportunistic infection typically affecting diabetic or immunocompromised patients. It clinically presents with symptoms that are non-specific including headache, low grade fever, facial swelling and orbital or paranasal sinus syndrome. The early imaging is helpful in assessing the extent of involvement of this lethal disease which requires prompt and aggressive treatment. Some of late disease of infection remains poor despite treatment. Hence early diagnosis with CT and MRI of Paranasal Sinuses, Orbit and Brick. Fungal culture and sensitivity is highly important for the course of the disease and patient's survival. The CT scan uses X-rays while MRIs use radio waves. Both are relatively at low risk but there are differences that make each one a better option depending on the circumstances. The study was carried out at the department of radio diagnosis in Muzaffar Nagar Medical College and Hospital. The inclusion criteria for patients in our study included the patients between ages 18 to 70 years who had clinical features suggestive of mucormycosis. The patients also had past history of COVID-19 infection and only had Rhinoorbital Cerebral form of mucormycosis. And the patients who were willing to give their consent for study were included in our study. The exclusion criteria included other forms of mucormycosis except Rhinoorbital Cerebral form and patients with past history of COVID-19 infections. We prospectively observed the Plain CT and Catalenium Contrast Enhanced MRI for Paranasal Sinuses, Orbit and Brain for 20 patients with clinical suspicion of Rhinoorbital Cerebral mucormycosis. The ethical approval was obtained for the study from the Ethics Committee of the Institute and written informed consent was taken from the patients or their guardian. All patients underwent non-contrast CT scanning with Siemens Somatom Scope 16-slice CT machine. The CT density was evaluated in non-enhanced images and compared with muscle or brain. MR imaging was done with Siemens Magnetom SN0-115 Tesla scanner. Both T1 and T2 weighted images were obtained as well as T1 weighted images after IV injection of gadopentritate dimaglumine and the dose of 0.1 millimole per kg. The images were evaluated for density, signal intensity and contrast enhancement characteristics. Clinical information about the presentation, management and evolution of the disease was obtained from the medical history in all cases and the data was entered in Microsoft Excel 2010 and statistical analysis was done using IBM SPSS V24.0. In CT, all the patients had mucosal thickening in perinazole sinuses and OSHA's involvement was noted in 30% of the patients. As we can see in this pie chart, the OSHA's involvement of perinazole sinuses is seen in only 30% of the patients while in rest of 70% there is no OSHA's involvement of the perinazole sinuses. Most of the patients had unilateral disease and the most common sinus involved was maxillary sinus followed by ithmoid sinus. The least commonly involved sinus was frontal sinus in only 25% of the patients. The most common pattern of signal characteristics on T2 weighted images was hypointensity followed by heterointense and hyperintense. On post contrast enhancement the most common pattern of enhancement was heterogeneous and peripheral which was followed by homogenous enhancement 15% patients did not show any enhancement on post contrast images. In this non-contrast CT of a 72 year old male, we can see that there is mucosal thickening in the ithmoid air cells and there is a large soft tissue mass causing bony erosion of cribriform plate and involvement of synod sinus with wall destruction. In this T1 post contrast MR image we can see there is hypointense pattern involving left ithmoid sinus. The pattern of in this T2 weighted MR image we can see there is heterogeneous pattern of involvement of the maxillary sinus as pointed by yellow arrow. In this T2 weighted MR image we can see there is hyperintense pattern as of the spinoid sinus. In this T2 weighted coronal image we can see there is mucosal thickening in the left nasal cavity and ithmoid sinus with hypointense contents within it. In this post contrast T1 weighted MR image we can see there is heterogeneous enhancement of pre orbital soft tissue and intra orbital lesion there is patchy heterogeneous enhancement in the left cavernous sinus as well. In MRI all the patients had hypointense lesions in T1 weighted image but the signal intensity characters of T2 weighted image were variable with most common being hypointense followed by heterointense and hyperintense. In post contrast enhancement pattern 15% of patients had non enhancement while 30% had heterogeneous and peripheral enhancement each and 25% had homogenous enhancement. The most common paranasal sinus to get involved is the maxillary sinus in almost 85% of cases and the least commonly involved sinus is the frontal sinus in only 25% of patients. For 30% of patients the OSHA's involvement was noted in CT scan. In our study CT feature of paranasal sinus involvement is the mucosal thickening which is an early manifestation of disease and also a nonspecific finding that may resemble acute or chronic rhinocinositis. Mucosal thickening of sinusitis can be differentiated from mucormicosis by correlating CT finding with clinical picture. This was in accordance with study done by Chan LL et al, Michael Arter et al and Nifn et al. Concluding the rhino orbital cerebral mucormicosis is an acute fatal infection with higher mortality rate due to its rapidly spreading nature. To decrease the mortality rate early diagnosis and intervention is needed. Catalinium contrast enhancement MRI of paranasal sinuses, orbit and brain can detect the early changes in optic nerve, paranasal sinuses and other extra sinus involvement. It also helps to delineate about the extent of disease thereby surgical interventions can be done accordingly and MRI prevails over CT scan in all the aspects that is perineural, base of skull, invasion, intracranial involvement and intraorbital changes detection except for the nauseous involvement for which CT scan is needed. These are my references. Thank you.