Fig. 11

SBO in ROCM. Axial T2W image of the brain (a) reveals bilateral sphenoid sinusitis (thin arrows). Coronal T2-FS image of the neck (b) demonstrates abnormal hyperintense marrow signals along the base of the sphenoid sinus and the greater wings of the sphenoid bone (thick arrows). Axial T2-FS image (c) shows oedematous swelling of the muscles of mastication (dotted arrows). CE FS coronal T1W image (d) demonstrates subtle abnormal marrow enhancement within the sphenoid bones (thick arrows) along with intense enhancement of the muscles of mastication (dotted arrows). Coronal CT image (e), using bone algorithm, confirms rarefaction of the sphenoid bones (thick arrow). Post-operative histopathology analysis (f), using HE staining, confirms Mucorales hyphae (thick arrow) with bone devitalisation and necrosis of the sphenoid bone (*)