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Research ArticleHead and Neck Imaging
Open Access

Quantitative Analysis of the Olfactory System in COVID-19: An MR Imaging Study

E. Altunisik, A.H. Baykan, S. Sahin, E. Aydin and S.M. Erturk
American Journal of Neuroradiology September 2021, DOI: https://doi.org/10.3174/ajnr.A7278
E. Altunisik
aFrom the Department of Neurology (E. Altunisik)
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A.H. Baykan
bRadiology (A.H.B.), Adiyaman University Faculty of Medicine, Adiyaman, Turkey
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S. Sahin
cDepartment of Radiology (S.S.), Adiyaman Training and Research Hospital, Adiyaman, Turkey
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E. Aydin
dDepartment of Radiology (E. Aydin), Baskent University Faculty of Medicine, Izmir, Turkey
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S.M. Erturk
eDepartment of Radiology (S.M.E), Istanbul University Faculty of Medicine, Istanbul, Turkey.
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  • FIG 1.
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    FIG 1.

    CONSORT flow diagram. HT indicates hypertension; DM, diabetes mellitus; TD, thyroid dysfunction; PD, Parkinson disease.

  • FIG 2.
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    FIG 2.

    Illustration of the olfactory system on coronal plane MR imaging. The medial orbital gyrus (red area), gyrus rectus (green area), olfactory sulcus (blue area), and olfactory bulb (brown area) are shown.

  • FIG 3.
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    FIG 3.

    Coronal 3D-FIESTA-C MR image of a 41-year-old man showing the right and left olfactory bulbs as hypointense ovoid structures (arrow). The olfactory sulcus (green dashed lines) is seen as a hyperintense line between the medial orbital gyrus (blue star) and gyrus rectus (yellow star). Note the hyperintense CSF surrounding the OBs.

  • FIG 4.
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    FIG 4.

    Sagittal multiplanar reconstruction of 3D-FIESTA-C MR imaging of a 27-year-old man showing the left olfactory tract (crosshairs).

  • FIG 5.
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    FIG 5.

    Coronal plane 3D-FIESTA-C MR images of a 33-year-old female patient with loss of smell who was proved to have COVID-19. The olfactory bulbs are seen as atrophic (A). The olfactory bulbs are still atrophic, though the loss of smell has improved, on MR image of the same patient 3 months later (B).

  • FIG 6.
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    FIG 6.

    Boxplots of the right OBV, left OBV, and total OBV values in both patient and control groups.

  • FIG 7.
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    FIG 7.

    Boxplots of the right OTL, left OTL, right OSD, and left OSD values in both patient and control groups.

  • FIG 8.
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    FIG 8.

    Coronal 3D FIESTA-C MR images of a 26-year-old male from control group (A) and a 25-year-old female patient with COVID-19 anosmia (B). Normal and increased signal intensity in bilateral olfactory bulbs (red and green arrows, respectively).

  • FIG 9.
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    FIG 9.

    Coronal 3D-FIESTA-C MR images of a 28-year-old man from the control group (A) and a 36-year-old female patient (B). Note normal and abnormal olfactory bulbs (red and green arrows, respectively) and olfactory sulci (red and green dashed lines, respectively).

  • FIG 10.
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    FIG 10.

    Sagittal multiplanar reconstruction of 3D-FIESTA-C MR images of a 42-year-old woman from the control group (A) and a 36-year-old female patient (B) showing normal and abnormal olfactory tracts (red and green arrows, respectively).

Tables

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    Table 1:

    Sex distribution and mean ages of the control and patient groups

    ControlPatientP
    Sex
     Male (No.) (%)36451747.2.824a
     Female (No.) (%)44551952.8
    Age (mean) (yr)35.74 (SD, 8.38)37.33 (SD, 7.38).329b
    • ↵a χ2 test.

    • ↵b Mann-Whitney U test.

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    Table 2:

    Demographic and clinical features of patients

    FeaturesNo. (%)
    Persistent headache19 (53%)
    Taste disturbance8 (22%)
    Vertigo/dizziness6 (17%)
    Pulmonary involvement2 (6%)
    Sinonasal symptoms0 (0%)
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    Table 3:

    Average, SD, and P values of OBV, OTL, and OSD measurements of patient and control groups

    PatientControlPa
    R OBV (mm3)41.57 (SD, 16.96)66.12 (SD, 16.86)<.001
    L OBV (mm3)40.76 (SD, 15.93)65.38 (SD, 18.80)<.001
    T OBV (mm3)82.34 (SD, 31.29)131.50 (SD, 32.27)<.001
    R OTL (mm)11.08 (SD, 2.18)12.85 (SD, 2.14)<.001
    L OTL (mm)11.24 (SD, 2.57)12.80 (SD, 2.60).003
    R OSD (mm)8.33 (SD, 1.65)9.20 (SD, 1.64).01
    L OSD (mm)8.64 (SD, 1.40)9.29 (SD, 1.53).033
    • Note:—R indicates right; L, left; T, total.

    • ↵a Independent t test.

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Cite this article
E. Altunisik, A.H. Baykan, S. Sahin, E. Aydin, S.M. Erturk
Quantitative Analysis of the Olfactory System in COVID-19: An MR Imaging Study
American Journal of Neuroradiology Sep 2021, DOI: 10.3174/ajnr.A7278

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Quantitative Analysis of the Olfactory System in COVID-19: An MR Imaging Study
E. Altunisik, A.H. Baykan, S. Sahin, E. Aydin, S.M. Erturk
American Journal of Neuroradiology Sep 2021, DOI: 10.3174/ajnr.A7278
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