Orbital cellulitis MRI: Difference between revisions

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Revision as of 16:07, 25 July 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tarek Nafee, M.D. [2]

Overview

On MRI scan of the head, orbital cellulitis is characterized by hypointense signal on T1-weighted fat-suppressed images, and hyperintense signal on T2-weighted fat-suppressed images.^[1] MRI has demonstrated equivalence to CT in diagnosing orbital disease and is also accepted as a gold standard diagnostic imaging modality.^[2]^[3]. Although an MRI scan is safer in children since there is no risk of radiation exposure, the long acquisition time and the need for prolonged sedation make CT scan the imaging modality of choice.^[2]^[4]

Key MRI Findings in Orbital Cellulitis

On MRI scan of the head, orbital cellulitis is characterized by hypointense signal on T1-weighted images, and hyperintense signal on T2-weighted images.^[1] MRI has demonstrated equivilance to CT in diagnosing orbital disease and is also accepted as a gold standard diagnostic imaging modality.^[2]^[3] Although an MRI scan is safer in children since there is no risk of radiation exposure, the long acquisition time and the need for prolonged sedation make CT scan the imaging modality of choice.^[4] After a diagnosis is made, MRI has shown superiority in assessing the severity of intracranial involvement and abscess border visualization.^[5]

MRI scans characterize subperiosteal and orbital abscesses on T1-weighted images with contrast as a rim-enhancing lesion.^[1] Diffuse weighted imaging (DWI) has shown promise of a non-contrast option for detecting orbital cellulitis and abscesses on MRI.^[2]^[3]^[6]^[7]^[8]

MRI Examples of Orbital Cellulitis

Examples of orbital cellulitis on MRI:^[1]

Orbital cellulitis with subperiosteal abscess on diffuse weighted imaging (DWI) MRI, showing apparent diffusion coefficient (ADC)

Orbital cellulitis with subperiosteal abscess on diffuse weighted imaging (DWI) MRI, showing apparent diffusion coefficient (ADC)
Orbital cellulitis on MRI

Orbital cellulitis on MRI

References

↑ ^1.0 ^1.1 ^1.2 ^1.3 Radiopaedia (2016)http://radiopaedia.org/articles/orbital-infection
↑ ^2.0 ^2.1 ^2.2 ^2.3 Sepahdari AR, Aakalu VK, Kapur R, Michals EA, Saran N, French A; et al. (2009). "MRI of orbital cellulitis and orbital abscess: the role of diffusion-weighted imaging". AJR Am J Roentgenol. 193 (3): W244–50. doi:10.2214/AJR.08.1838. PMID 19696266.
↑ ^3.0 ^3.1 ^3.2 Merck Manual Professional Edition (2016)https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/preseptal-and-orbital-cellulitis
↑ ^4.0 ^4.1 American Academy of Ophthalmology EyeWiki (2015)http://eyewiki.aao.org/Orbital_Cellulitis#Diagnostic_procedures
↑ Mair MH, Geley T, Judmaier W, Gassner I (2002). "Using orbital sonography to diagnose and monitor treatment of acute swelling of the eyelids in pediatric patients". AJR Am J Roentgenol. 179 (6): 1529–34. doi:10.2214/ajr.179.6.1791529. PMID 12438049.
↑ Chaudhry IA, Al-Rashed W, Arat YO (2012). "The hot orbit: orbital cellulitis". Middle East Afr J Ophthalmol. 19 (1): 34–42. doi:10.4103/0974-9233.92114. PMC 3277022. PMID 22346113.
↑ LeBedis CA, Sakai O (2008). "Nontraumatic orbital conditions: diagnosis with CT and MR imaging in the emergent setting". Radiographics. 28 (6): 1741–53. doi:10.1148/rg.286085515. PMID 18936033.
↑ Yousem DM (1993). "Imaging of sinonasal inflammatory disease". Radiology. 188 (2): 303–14. doi:10.1148/radiology.188.2.8327669. PMID 8327669.

Template:WH Template:WS

[radiopaedia-1] 1.0 ^1.1 ^1.2 ^1.3 Radiopaedia (2016)http://radiopaedia.org/articles/orbital-infection

[pmid19696266-2] 2.0 ^2.1 ^2.2 ^2.3 Sepahdari AR, Aakalu VK, Kapur R, Michals EA, Saran N, French A; et al. (2009). "MRI of orbital cellulitis and orbital abscess: the role of diffusion-weighted imaging". AJR Am J Roentgenol. 193 (3): W244–50. doi:10.2214/AJR.08.1838. PMID 19696266.

[merckmanualorbitalcellulitis-3] 3.0 ^3.1 ^3.2 Merck Manual Professional Edition (2016)https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/preseptal-and-orbital-cellulitis

[eyewikiorbitalcellulitis-4] 4.0 ^4.1 American Academy of Ophthalmology EyeWiki (2015)http://eyewiki.aao.org/Orbital_Cellulitis#Diagnostic_procedures

[pmid12438049-5] Mair MH, Geley T, Judmaier W, Gassner I (2002). "Using orbital sonography to diagnose and monitor treatment of acute swelling of the eyelids in pediatric patients". AJR Am J Roentgenol. 179 (6): 1529–34. doi:10.2214/ajr.179.6.1791529. PMID 12438049.

[pmid22346113-6] Chaudhry IA, Al-Rashed W, Arat YO (2012). "The hot orbit: orbital cellulitis". Middle East Afr J Ophthalmol. 19 (1): 34–42. doi:10.4103/0974-9233.92114. PMC 3277022. PMID 22346113.

[pmid18936033-7] LeBedis CA, Sakai O (2008). "Nontraumatic orbital conditions: diagnosis with CT and MR imaging in the emergent setting". Radiographics. 28 (6): 1741–53. doi:10.1148/rg.286085515. PMID 18936033.

[pmid8327669-8] Yousem DM (1993). "Imaging of sinonasal inflammatory disease". Radiology. 188 (2): 303–14. doi:10.1148/radiology.188.2.8327669. PMID 8327669.

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@@ Line 6: / Line 6: @@
 ==Key MRI Findings in Orbital Cellulitis==
-On MRI scan of the head, orbital cellulitis is characterized by hypointense signal on T1-weighted images, and hyperintense signal on T2-weighted images.<ref name=radiopaedia>Radiopaedia (2016)http://radiopaedia.org/articles/orbital-infection</ref> MRI has demonstrated equivilance to CT in diagnosing orbital disease and is also accepted as a gold standard diagnostic imaging modality. (Sephadari & Merck). Although an MRI scan is safer in children since there is no risk of radiation exposure, the long acquisition time and the need for prolonged sedation make CT scan the imaging modality of choice.<ref name=eyewikiorbitalcellulitis>American Academy of Ophthalmology EyeWiki (2015)http://eyewiki.aao.org/Orbital_Cellulitis#Diagnostic_procedures</ref> After a diagnosis is made, MRI has shown superiority in assessing the severity of intracranial involvement and abscess border visualization.<ref name="pmid12438049">{{cite journal| author=Mair MH, Geley T, Judmaier W, Gassner I| title=Using orbital sonography to diagnose and monitor treatment of acute swelling of the eyelids in pediatric patients. | journal=AJR Am J Roentgenol | year= 2002 | volume= 179 | issue= 6 | pages= 1529-34 | pmid=12438049 | doi=10.2214/ajr.179.6.1791529 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12438049  }} </ref>
+On MRI scan of the head, orbital cellulitis is characterized by hypointense signal on T1-weighted images, and hyperintense signal on T2-weighted images.<ref name=radiopaedia>Radiopaedia (2016)http://radiopaedia.org/articles/orbital-infection</ref> MRI has demonstrated equivilance to CT in diagnosing orbital disease and is also accepted as a gold standard diagnostic imaging modality.<ref name="pmid19696266">{{cite journal| author=Sepahdari AR, Aakalu VK, Kapur R, Michals EA, Saran N, French A et al.| title=MRI of orbital cellulitis and orbital abscess: the role of diffusion-weighted imaging. | journal=AJR Am J Roentgenol | year= 2009 | volume= 193 | issue= 3 | pages= W244-50 | pmid=19696266 | doi=10.2214/AJR.08.1838 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19696266  }} </ref><ref name=merckmanualorbitalcellulitis>Merck Manual Professional Edition (2016)https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/preseptal-and-orbital-cellulitis</ref> Although an MRI scan is safer in children since there is no risk of radiation exposure, the long acquisition time and the need for prolonged sedation make CT scan the imaging modality of choice.<ref name=eyewikiorbitalcellulitis>American Academy of Ophthalmology EyeWiki (2015)http://eyewiki.aao.org/Orbital_Cellulitis#Diagnostic_procedures</ref> After a diagnosis is made, MRI has shown superiority in assessing the severity of intracranial involvement and abscess border visualization.<ref name="pmid12438049">{{cite journal| author=Mair MH, Geley T, Judmaier W, Gassner I| title=Using orbital sonography to diagnose and monitor treatment of acute swelling of the eyelids in pediatric patients. | journal=AJR Am J Roentgenol | year= 2002 | volume= 179 | issue= 6 | pages= 1529-34 | pmid=12438049 | doi=10.2214/ajr.179.6.1791529 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12438049  }} </ref>
 MRI scans characterize subperiosteal and orbital abscesses on T1-weighted images with contrast as a rim-enhancing lesion.<ref name=radiopaedia>Radiopaedia (2016)http://radiopaedia.org/articles/orbital-infection</ref> Diffuse weighted imaging (DWI) has shown promise of a non-contrast option for detecting orbital cellulitis and abscesses on MRI.<ref name="pmid19696266">{{cite journal| author=Sepahdari AR, Aakalu VK, Kapur R, Michals EA, Saran N, French A et al.| title=MRI of orbital cellulitis and orbital abscess: the role of diffusion-weighted imaging. | journal=AJR Am J Roentgenol | year= 2009 | volume= 193 | issue= 3 | pages= W244-50 | pmid=19696266 | doi=10.2214/AJR.08.1838 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19696266  }} </ref><ref name=merckmanualorbitalcellulitis>Merck Manual Professional Edition (2016)https://www.merckmanuals.com/professional/eye-disorders/orbital-diseases/preseptal-and-orbital-cellulitis</ref><ref name="pmid22346113">{{cite journal| author=Chaudhry IA, Al-Rashed W, Arat YO| title=The hot orbit: orbital cellulitis. | journal=Middle East Afr J Ophthalmol | year= 2012 | volume= 19 | issue= 1 | pages= 34-42 | pmid=22346113 | doi=10.4103/0974-9233.92114 | pmc=3277022 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22346113  }} </ref><ref name="pmid18936033">{{cite journal| author=LeBedis CA, Sakai O| title=Nontraumatic orbital conditions: diagnosis with CT and MR imaging in the emergent setting. | journal=Radiographics | year= 2008 | volume= 28 | issue= 6 | pages= 1741-53 | pmid=18936033 | doi=10.1148/rg.286085515 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18936033  }} </ref><ref name="pmid8327669">{{cite journal| author=Yousem DM| title=Imaging of sinonasal inflammatory disease. | journal=Radiology | year= 1993 | volume= 188 | issue= 2 | pages= 303-14 | pmid=8327669 | doi=10.1148/radiology.188.2.8327669 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8327669  }} </ref>