Figure 29.

Invasive fungal sinusitis in a 20-year-old male patient. (A) Axial and (B) coronal postcontrast T1W images show large areas of hypointense non-enhancing soft tissue involving the left nasal cavity, maxillary sinus, nasal turbinates, masticator space, and nasopharynx, consistent with devitalized tissue (‘black turbinate’ sign). (C) Axial T2W and (D) postcontrast fat-suppressed T1W images reveal extension into the left cavernous sinus with left cavernous ICA encasement and narrowing (white arrow). There is also parenchymal edema in the left anteromedial temporal lobe (blue arrow).