ct scan eye slide presentation
DESCRIPTION
few slides from my collection in ZambiaTRANSCRIPT
Imaging eye lesionImaging eye lesion
DR. Rekha KhareDR. Rekha Khare
M.D. RadiologyM.D. Radiology
Common clinical problem Common clinical problem to imageto image
PROPTOSISPROPTOSIS
ProptosisProptosis
It is abnormal protrusion of eye ballIt is abnormal protrusion of eye ball
_unilateral_unilateral
_bilateral_bilateral
Causes of proptosisCauses of proptosis
V_ vascular ( av malformation )V_ vascular ( av malformation ) E_ endocrinal ( thyrotoxicosis ) E_ endocrinal ( thyrotoxicosis ) I_ Infection/ inflammationI_ Infection/ inflammation N_ neoplasm ( primary/ secondary )N_ neoplasm ( primary/ secondary )
( local/ intracranial )( local/ intracranial )
Imaging modalityImaging modality
Plain X- ray_ no valuePlain X- ray_ no value Ultrasound_ little helpUltrasound_ little help CT scanCT scan MRI scanMRI scan
CT versus MRICT versus MRI
MRI_ superb tissue contrastMRI_ superb tissue contrast
choice of imaging if available and choice of imaging if available and
affordableaffordable
Contd.Contd.
CT scan_CT scan_
-tissue contrast just comparable -tissue contrast just comparable -easily affordable and available -easily affordable and available
-easy assessment of PNS/ nasal cavity -easy assessment of PNS/ nasal cavity and or bone involvementand or bone involvement
-intracranial extension -intracranial extension
“ “Common diagnostic tool in routine”Common diagnostic tool in routine”
What to see on CT scan?What to see on CT scan?
eye balleye ball eye muscles ( extra ocular )eye muscles ( extra ocular ) retro bulbar spaceretro bulbar space optic nerveoptic nerve bony socket bony socket adjoining paranasal sinus/ nasal cavityadjoining paranasal sinus/ nasal cavity intracranial tissue intracranial tissue
Eye image on CT scanEye image on CT scan
Eye mass_ proptosisEye mass_ proptosis
Ring enhancedRing enhanced
cystic lesion in Rt.cystic lesion in Rt.
retro bulbar retro bulbar regionregion
? abscess ? abscess (HIV+ve)(HIV+ve)
Eye mass_ proptosisEye mass_ proptosis
Ring enhancedRing enhanced
lesion in retrolesion in retro
bulbar regionbulbar region
+ ethmoidal + ethmoidal
sinusitissinusitis
? abscess ? abscess
Eye mass_ proptosisEye mass_ proptosis
Retrobulbar massRetrobulbar mass
nature?nature?
Eye mass_ Proptosis Eye mass_ Proptosis
HomogenousHomogenous
enhanced enhanced
few calcification few calcification obscuring obscuring
optic nerveoptic nerve
? Meningioma? Meningioma
Same caseSame case
RetrobulbarRetrobulbar
mass mass compressing compressing extraocular extraocular muscles muscles deforming eye deforming eye ballball
ProptosisProptosis
Thick extraocular Thick extraocular muscles andmuscles and
Optic nerveOptic nerve
(HIV+ve case)(HIV+ve case)
? Lymphoma? Lymphoma
D/D thyrotoxicosisD/D thyrotoxicosis
( fusiform muscles)( fusiform muscles)
ThyrotoxicosisThyrotoxicosis
fusiform fusiform extraocular muscleextraocular muscle
Same caseSame case
ThyrotoxicosisThyrotoxicosis
Eye mass_ proptosisEye mass_ proptosis
Soft tissue mass Soft tissue mass
obscuring optic obscuring optic nerve infiltrating nerve infiltrating lat. muscle ? lat. muscle ? Optic nerve Optic nerve sheath sheath meningioma meningioma
Eye mass_ proptosisEye mass_ proptosis
Enhanced mass Enhanced mass medial medial retrobulbar region retrobulbar region displacing optic displacing optic nerve?nerve?
pseudo- tumourpseudo- tumour
Eye mass_ proptosis Eye mass_ proptosis
Enhanced mass Enhanced mass from extraocularfrom extraocular musclemuscle?Lymphoma?Lymphoma?? rhabdomyosarcoma?? rhabdomyosarcoma
Eye mass_ proptosisEye mass_ proptosis
Heterogenous Heterogenous enhanced mass enhanced mass filling retrobulbar filling retrobulbar region, deforming region, deforming eye ball? eye ball? Malignant mass Malignant mass
Extra orbital lesionsExtra orbital lesions
Lesions can cause proptosis if fromLesions can cause proptosis if from
paranasal sinus/ nasal cavity or paranasal sinus/ nasal cavity or
intracranial mass extension orintracranial mass extension or
bones in surrounding bones in surrounding
Proptosis _ post. op caseProptosis _ post. op case
Intracranial mass/ Intracranial mass/
abscess with bone abscess with bone destructiondestruction
Check next sliceCheck next slice
Same caseSame case
Extracerebral Extracerebral mass/abscess mass/abscess drainage donedrainage done
aggressive infectionaggressive infection
gone deep gone deep
ProptosisProptosis
Calcific density Calcific density mass Rt. mass Rt. Retrobulbar Retrobulbar pushing eye ball pushing eye ball anteriorlyanteriorly
? Congenital bony ? Congenital bony DysplasiaDysplasia
ProptosisProptosis
Extra orbital Extra orbital midline malignant midline malignant mass from base mass from base of skull of skull
Paranasal sinusParanasal sinus
Nonenhanced Nonenhanced expansile cystic expansile cystic
mass lesion in Rt.mass lesion in Rt.
frontal sinusfrontal sinus
? mucocele ? mucocele
Paranasal sinusParanasal sinus
Nonenhanced Nonenhanced expansile cystic expansile cystic mass lesion in Rt.mass lesion in Rt.
frontal sinusfrontal sinus
? mucocele? mucocele
Paranasal sinusParanasal sinus
Frontal mucoceleFrontal mucocele
Paranasal sinusParanasal sinus
Huge soft tissue Huge soft tissue mass displacingmass displacing
and compressing and compressing eye ball ? eye ball ?
ethmoidal ethmoidal mucocelemucocele
Paranasal SinusParanasal Sinus
Ethmoidal mucoceleEthmoidal mucocele
Paranasal sinusParanasal sinus
Nonenhanced Nonenhanced expansile expansile
cystic lesion in cystic lesion in sphenoidal sinussphenoidal sinus
?mucocele?mucocele
might cause might cause proptosis if hugeproptosis if huge
Paranasal sinus_ massParanasal sinus_ mass
Paranasal sinus Paranasal sinus mass extending mass extending orbital fossaorbital fossa
Other paranasal sinus Other paranasal sinus lesionlesion
Few paranasal sinus lesions might causeFew paranasal sinus lesions might cause
eye problem or proptosis if the lesion is eye problem or proptosis if the lesion is severe severe
Paranasal sinusesParanasal sinuses
Thin wall Thin wall enhanced enhanced lobulated cystic lobulated cystic mass in both mass in both maxillary sinusesmaxillary sinuses
? Mucosal cyst ? Mucosal cyst
Paranasal sinusesParanasal sinuses
Air fluid level in Air fluid level in Rt. Maxillary Rt. Maxillary sinussinus
? sinusitis? sinusitis
Paranasal sinusesParanasal sinuses
Irregular mucosal Irregular mucosal thickening Lt.thickening Lt.
maxillary sinusmaxillary sinus Calcified mucosa Calcified mucosa
Rt. Maxillary Rt. Maxillary sinussinus
? Chronic sinusitis? Chronic sinusitis
Mass faceMass face
Mass Rt maxillary Mass Rt maxillary antrum, filling antrum, filling nasal cavity, nasal cavity, crossing midlinecrossing midline
? malignancy? malignancy
Mass faceMass face
AdvanceAdvance
malignancymalignancy
Rt. maxillaryRt. maxillary
antrumantrum
Intracranial massIntracranial mass
well enhancedwell enhanced
suprasellar masssuprasellar mass
involving Rt. Opticinvolving Rt. Optic
nerve?nerve?
meningiomameningioma
Same caseSame case
Huge mass Huge mass
with with
hydrocephalushydrocephalus
AVMAVM
dilated sup. dilated sup. Ophth.veinOphth.vein