Feasibility of rapid magnetic resonance imaging (rMRI) for the emergency evaluation of suspected pediatric orbital cellulitis

Jain, Samiksha; Ishihara, Rhys; Wheelock, Lisa; Love, Terri; Wang, Jennifer; Deegan, T.; Majerus, Chelsea R.; Oarhe, Christian; Allbery, Sandra M.

doi:10.1016/j.jaapos.2020.05.018

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…Magnetic resonance imaging (MRI) is helpful for evaluating intracranial complications (eg, epidural abscess), 27,37 but it is limited for evaluating the osseous components of the paranasal sinuses. Although one study suggested that rapid MRI is comparable to contrast CT for differentiating group 1 infections from groups 2, 3, and 4 infections, it provided limited assessment of other complications 38 . With no definitive studies comparing CT with MRI for orbital infections, adherence to the ACR criteria is recommended.…”

Section: Resultsmentioning

confidence: 99%

“…Although one study suggested that rapid MRI is comparable to contrast CT for differentiating group 1 infections from groups 2, 3, and 4 infections, it provided limited assessment of other complications. 38 With no definitive studies comparing CT with MRI for orbital infections, adherence to the ACR criteria is recommended.…”

Section: What Type Of Imaging Should Be Obtained?mentioning

confidence: 99%

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Evaluation and Medical Management of the Pediatric Patient With Orbital Cellulitis/Abscess: A Systematic Review

Burek

Melamed

Liljestrom

et al. 2021

Journal of Hospital Medicine

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BACKGROUND AND OBJECTIVES: Pediatric orbital cellulitis/abscess (OCA) can lead to vision loss, intracranial extension of infection, or cavernous thrombosis if not treated promptly. No widely recognized guidelines exist for the medical management of OCA. The objective of this review was to summarize existing evidence regarding the role of inflammatory markers in distinguishing disease severity and need for surgery; the role of imaging in OCA evaluation; and the microbiology of OCA over the past 2 decades. METHODS: This review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in MEDLINE (Ovid), Web of Science Core Collection, Scopus, CINAHL (EBSCO), and Cochrane Central Register of Controlled Trials (CENTRAL), most recently on February 9, 2021. RESULTS: A total of 63 studies were included. Most were descriptive and assessed to have poor quality with high risk of bias. The existing publications evaluating inflammatory markers in the diagnosis of OCA have inconsistent results. Computed tomography imaging remains the modality of choice for evaluating orbital infection. The most common organisms recovered from intraoperative cultures are Streptococcus species (Streptococcus anginosus group, group A Streptococcus, and pneumococcus) and Staphylococcus aureus. Methicillin-resistant S aureus in culture-positive cases had a median prevalence of 3% (interquartile range, 0%-13%). CONCLUSION: This systematic review summarizes existing literature concerning inflammatory markers, imaging, and microbiology for OCA evaluation and management. High-quality evidence is still needed to define the optimal medical management of OCA.

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Section: Resultsmentioning

confidence: 99%

Section: What Type Of Imaging Should Be Obtained?mentioning

confidence: 99%

Evaluation and Medical Management of the Pediatric Patient With Orbital Cellulitis/Abscess: A Systematic Review

Burek

Melamed

Liljestrom

et al. 2021

Journal of Hospital Medicine

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“…Rapid MRI has been employed to address different pediatric imaging needs. [4][5][6][7] These methods rely on accelerating data acquisition using parallel imaging [8], compressed sensing [9][10][11][12][13], non-Cartesian imaging [14], and simultaneous multi-slice imaging. [15] Quantitative imaging: Dixon et al [16] analyzed 550 pediatric patients with brain tumors and showed the accuracy of qualitative diagnostic imaging.…”

Section: Introductionmentioning

confidence: 99%

Tailored magnetic resonance fingerprinting of post-operative pediatric brain tumor patients

Poojar

Qian

Jin

et al. 2022

Preprint

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Purpose: Brain and spinal cord tumors are the second most common cancer in children and account for one out of four cancers diagnosed. However, the long acquisition times associated with acquiring both data types prohibit using quantitative MR (qMR) in pediatric imaging protocols. This study aims to demonstrate the tailored magnetic resonance fingerprinting's (TMRF) ability to simultaneously provide quantitative maps (T1, T2) and multi-contrast qualitative images (T1 weighted, T1 FLAIR, T2 weighted) rapidly in pediatric brain tumor patients. Methods: In this work, we imaged five pediatric patients with brain tumors (resected/residual) using TMRF at 3T. We compared the TMRF-derived T2 weighted images with those from the vendor-supplied sequence (as the gold standard, GS) for healthy and pathological tissue signal intensities. The relaxometric maps from TMRF were subjected to a region of interest (ROI) analysis to differentiate between healthy and pathological tissues. We performed the Wilcoxon rank sum test to check for significant differences between the two tissue types. Results: We found significant differences (P < 0.05) in both T1 and T2 ROI values between the two tissue types. A strong correlation was found between the TMRF-based T2 weighted and GS signal intensities for the healthy (correlation coefficient, r = 0.99) and pathological tissues (r = 0.88). Conclusion: The TMRF implementation provides the two relaxometric maps and can potentially save ~2 minutes if it replaces the T2-weighted imaging in the current protocol.

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Imaging of the Orbit: “Current Concepts”

de Win

2023

Surgery in and Around the Orbit

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Orbital imaging with CT or MRI can be essential in the evaluation of many orbital conditions. Because of its superior bony characterization and fast acquisition, CT is imaging method of first choice in urgent situations like trauma, infection, and evaluation of lesions arising from the orbital wall. Through recent years, CT has also gained a prominent role in (pre)operative planning and navigation, especially through the development of postprocessing software. For the evaluation of more complex orbital disease, MRI is the preferred modality. With its superior soft-tissue differentiation, MRI is useful for determining the extent of orbital lesions, like inflammatory disease, vascular malformations, and orbital tumors. By adding functional MRI techniques, like diffusion and perfusion-weighted imaging, and by combining parameters of different imaging techniques in multiparametric imaging, it is possible to further improve characterization of orbital lesions. In this chapter, the optimal approach to orbital imaging is described, combining knowledge of orbital imaging techniques and imaging indications, together with a structured way of reviewing the orbital images, knowledge of radiological features of common, and more uncommon orbital pathology, and integrating this with the clinical features of the patient.

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Feasibility of rapid magnetic resonance imaging (rMRI) for the emergency evaluation of suspected pediatric orbital cellulitis

Cited by 6 publications

References 15 publications

Evaluation and Medical Management of the Pediatric Patient With Orbital Cellulitis/Abscess: A Systematic Review

Evaluation and Medical Management of the Pediatric Patient With Orbital Cellulitis/Abscess: A Systematic Review

Tailored magnetic resonance fingerprinting of post-operative pediatric brain tumor patients

Imaging of the Orbit: “Current Concepts”

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