Diagnostic Accuracy of MRI in Invasive Fungal Rhinosinusitis Affecting Diabetics taking Histopathology as Gold Standard

Background: Diabetes is an alarmingly prevalent disease in Pakistan, affecting 26.7 % of adult population according to International Diabetic Federation (IDF). Fungal sinus infections and their complications, being dominant in immunocompromised diabetic patients, need to be diagnosed timely with MRI imaging to avoid devastating complications. Objective: The main objective of our research is to prove diagnostic accuracy of MRI for the diagnosis of invasive fungal rhinosinusitis among diabetic, immuno-compromised patients. Method: We performed an analytical cross-sectional study spanning ten months (May 2024 till February 2025) at the Radiology Department of Services Hospital, Lahore. Non-probability consecutive sampling technique was utilized through which 191 diabetic patients of age 35 to 50 years from both genders affected by invasive fungal rhinosinusitis were enrolled to constitute the study population. Each subject was examined using pre and post contrast MRI of paranasal sinuses, following which, histopathological confirmation was made and the results were analyzed using SPSS version 25.0 software to measure diagnostic accuracy of MRI taking histopathology as gold standard. Results: Among the 191 diabetic patients, most of them fell in the age range of 40 to 50 years (72%) while the rest of them were aged 35 to 39 years (28%). The mean age was 42.76 years ± 5.37 years. Pre contrast MRI accompanied by Post contrast MRI has Sensitivity: 84.37%, Specificity: 88.05 %, PPV: 58.69%, NPV: 96.55 %, along with overall accuracy: 87.43 % to detect invasive fungal rhinosinusitis. Conclusion: Magnetic resonance imaging has substantial sensitivity and specificity for diagnosing Invasive Fungal Rhinosinusitis with high degree of confidence, furthermore it pinpoints localization of extra sinus fungal invasion to provide a roadmap for surgical planning thus evading critical consequences.