Imaging of Orbital Trauma and Emergent Non-traumatic Conditions

Winegar, Blair A.; Gutiérrez, Juan Escribano

doi:10.1016/j.nic.2015.05.007

Cited by 21 publications

(7 citation statements)

References 35 publications

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“…With an incidence of only 0.2%, CCF are very rare vasculopathies after trauma [31]. Nevertheless, their typical findings, a dilatation of the superior ophthalmic vein, as well as proptosis, enlarged cavernous sinus and extraocular muscles, and orbital edema should initiate further invasive diagnostics through cerebral angiography [12,14].…”

Section: Discussionmentioning

confidence: 99%

“…Even though MRI provides superior soft tissue contrast when compared to MSCT, and ultrasonography can survey the ocular globe precisely, MRI is less relevant in the acute setting due to long acquisition times as well as the possible risk of dislocation of metallic foreign bodies [10], and ultrasonography is contraindicated in cases of suspected globe rupture [11]. Nevertheless, contrast-enhanced MSCT can depict most soft tissue injuries accurately [12,13], and even hint to underlying carotid-cavernous fistulas (CCF) when dilated superior ophthalmic veins, exophthalmos, and orbital edema are present [14]. Furthermore, radiopaque intraorbital foreign bodies including glass fragments can be identified with a sensitivity of up to 90% on MSCT [2,15].…”

Section: Introductionmentioning

confidence: 99%

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Retrospective Cohort Study of Frequency and Patterns of Orbital Injuries on Whole-Body CT with Maxillofacial Multi-Slice CT

et al. 2021

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Background: High-impact trauma frequently leads to injuries of the orbit, but literature focusing on the viscerocranium rather than the neurocranium is underrepresented. Methods: Retrospective cohort study (2006–2014) at an urban level 1 trauma center assessing the frequency and typical patterns of orbital injuries on whole-body computed tomography (WBCT) with maxillofacial multi-slice CT (MSCT) after severe trauma. (1) Screening of consecutive WBCT cases for dedicated maxillofacial MSCT. (2) Examination by two independent experts’ radiologists for (peri-/)orbital injuries. (3) Case review for trauma mechanisms. Results: 1061 WBCT were included revealing 250 (23.6%) patients with orbital injuries. Less than one-quarter (23.3%) of patients showed osseous and 9.5% showed soft tissue injuries. Combined osseous and soft tissue lesions were present in 39.2% of orbital injuries, isolated soft tissue injuries were rare. Single- or two-wall fractures of the orbit were prevalent, and the orbital floor was affected in 67% of fractures. Dislocated extraocular muscles (44.6%), deformation of the ocular globe (23.8%), and elongation of the optic nerve (12.9%) were the most frequently soft tissue findings. Vascular trauma was suspected in 15.8% of patients. Conclusions: Orbital trauma was confirmed in 23.6% of cases with suspected facial injuries after severe trauma. Concomitant soft tissue injuries should be excluded explicitly in cases with orbital fractures to prevent loss of vision or ocular motility.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Retrospective Cohort Study of Frequency and Patterns of Orbital Injuries on Whole-Body CT with Maxillofacial Multi-Slice CT

et al. 2021

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“…Cavernous carotid fistula can be traumatic or spontaneous, and can be supplied directly by the internal carotid artery, indirectly by branches of the internal or external carotid artery, or both. 25 CT angiography is more sensitive for detection of an cavernous carotid fistula than MR angiography, although both demonstrate similar findings of enlarged cavernous sinus, enlarged superior ophthalmic vein, proptosis, and enlargement of the EOMs. 26 Digital subtraction angiography is required for definitive diagnosis of cavernous carotid fistula.…”

Section: Imagingmentioning

confidence: 92%

“…26 Digital subtraction angiography is required for definitive diagnosis of cavernous carotid fistula. 25 The clinical findings in a young patient who presented with a 2-month history of right eye proptosis are demonstrated in Fig 16, found to be secondary to IgG4 related orbitopathy. IgG4-related disease is a systemic inflammatory process of unknown etiology that can involve multiple different organs and organ systems.…”

Section: Imagingmentioning

confidence: 99%

Decoding the Ophthalmology Note: Understanding Clinical Symptoms and Physical Examination Findings in the Context of Imaging Pathology

Cavazuti¹,

Chen²,

Aiken³

et al. 2017

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The American Society of Neuroradiology (ASNR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The ASNR designates this enduring material for a maximum of one AMA PRA Category one credit TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To obtain credit for this activity, an online quiz must be successfully completed and submitted. ASNR members may access this quiz at no charge by logging on to eCME at http://members.asnr.org. Nonmembers may pay a small fee to access the quiz and obtain credit via http://members.asnr.org/ecme.

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“…Displaced fractures with considerable lateral angulation of the orbital internal lateral wall or simultaneous orbital floor blowout fractures can cause enophthalmos, which requires urgent surgical correction and intraorbital reconstruction [ 31 ]. CT is crucial in determining the degree of comminution and angulation of the internal lateral orbital wall, as well as the presence of a concurrent floor fracture: in this case, the presence of inferior rectus muscle entrapment should be assessed [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

Computed tomography in traumatic orbital emergencies: a pictorial essay—imaging findings, tips, and report flowchart

et al. 2022

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Computed tomography (CT) is considered the gold standard technique for the assessment of trauma patients with suspected involvement of the eye and orbit. These traumas can result in dramatic consequences to visual function, ocular motility, and aesthetics. CT is a quick and widely available imaging modality, which provides a detailed evaluation of the orbital bony and soft tissue structures, an accurate assessment of the globes, and is used to guide the patients’ treatment planning. For a timely and accurate diagnosis, radiologists should be aware of fracture patterns and possible associated complications, ocular detachments and hemorrhages, and different appearances of intraorbital foreign bodies. This educational review aims to describe all post-traumatic orbital abnormalities that can be identified on CT, providing a list of tips and a diagnostic flowchart to help radiologists deal with this complex condition.

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Imaging of Orbital Trauma and Emergent Non-traumatic Conditions

Cited by 21 publications

References 35 publications

Retrospective Cohort Study of Frequency and Patterns of Orbital Injuries on Whole-Body CT with Maxillofacial Multi-Slice CT

Retrospective Cohort Study of Frequency and Patterns of Orbital Injuries on Whole-Body CT with Maxillofacial Multi-Slice CT

Decoding the Ophthalmology Note: Understanding Clinical Symptoms and Physical Examination Findings in the Context of Imaging Pathology

Computed tomography in traumatic orbital emergencies: a pictorial essay—imaging findings, tips, and report flowchart

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