Ct scan eye slide presentation

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few slides from my collection in Zambia

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Ct scan eye slide presentation

  1. 1. Imaging eye lesion DR. Rekha Khare M.D. Radiology
  2. 2. Common clinical problem to image <ul><li>PROPTOSIS </li></ul>
  3. 3. Proptosis <ul><li>It is abnormal protrusion of eye ball </li></ul><ul><li>_unilateral </li></ul><ul><li>_bilateral </li></ul>
  4. 4. Causes of proptosis <ul><li>V_ vascular ( av malformation ) </li></ul><ul><li>E_ endocrinal ( thyrotoxicosis ) </li></ul><ul><li>I_ Infection/ inflammation </li></ul><ul><li>N_ neoplasm ( primary/ secondary ) </li></ul><ul><li>( local/ intracranial ) </li></ul>
  5. 5. Imaging modality <ul><li>Plain X- ray_ no value </li></ul><ul><li>Ultrasound_ little help </li></ul><ul><li>CT scan </li></ul><ul><li>MRI scan </li></ul>
  6. 6. CT versus MRI <ul><li>MRI_ superb tissue contrast </li></ul><ul><li>choice of imaging if available and </li></ul><ul><li>affordable </li></ul>
  7. 7. Contd. <ul><li>CT scan_ </li></ul><ul><li>-tissue contrast just comparable -easily affordable and available </li></ul><ul><li>-easy assessment of PNS/ nasal cavity and or bone involvement </li></ul><ul><li>-intracranial extension </li></ul><ul><li>“Common diagnostic tool in routine” </li></ul>
  8. 8. What to see on CT scan? <ul><li>eye ball </li></ul><ul><li>eye muscles ( extra ocular ) </li></ul><ul><li>retro bulbar space </li></ul><ul><li>optic nerve </li></ul><ul><li>bony socket </li></ul><ul><li>adjoining paranasal sinus/ nasal cavity </li></ul><ul><li>intracranial tissue </li></ul>
  9. 9. Eye image on CT scan
  10. 10. Eye mass_ proptosis <ul><li>Ring enhanced </li></ul><ul><li>cystic lesion in Rt. </li></ul><ul><li>retro bulbar region </li></ul><ul><li>? abscess (HIV+ve) </li></ul>
  11. 11. Eye mass_ proptosis <ul><li>Ring enhanced </li></ul><ul><li>lesion in retro </li></ul><ul><li>bulbar region </li></ul><ul><li>+ ethmoidal </li></ul><ul><li>sinusitis </li></ul><ul><li>? abscess </li></ul>
  12. 12. Eye mass_ proptosis <ul><li>Retrobulbar mass </li></ul><ul><li>nature? </li></ul>
  13. 13. Eye mass_ Proptosis <ul><li>Homogenous </li></ul><ul><li>enhanced </li></ul><ul><li>few calcification obscuring </li></ul><ul><li>optic nerve </li></ul><ul><li>? Meningioma </li></ul>
  14. 14. Same case <ul><li>Retrobulbar </li></ul><ul><li>mass compressing extraocular muscles deforming eye ball </li></ul>
  15. 15. Proptosis <ul><li>Thick extraocular muscles and </li></ul><ul><li>Optic nerve </li></ul><ul><li>(HIV+ve case) </li></ul><ul><li>? Lymphoma </li></ul><ul><li>D/D thyrotoxicosis </li></ul><ul><li>( fusiform muscles) </li></ul>
  16. 16. Thyrotoxicosis <ul><li>fusiform extraocular muscle </li></ul>
  17. 17. Same case <ul><li>Thyrotoxicosis </li></ul>
  18. 18. Eye mass_ proptosis <ul><li>Soft tissue mass </li></ul><ul><li>obscuring optic nerve infiltrating lat. muscle ? Optic nerve sheath meningioma </li></ul>
  19. 19. Eye mass_ proptosis <ul><li>Enhanced mass medial retrobulbar region displacing optic nerve? </li></ul><ul><li>pseudo- tumour </li></ul>
  20. 20. Eye mass_ proptosis <ul><li>Enhanced mass </li></ul><ul><li>from extraocular </li></ul><ul><li>muscle </li></ul><ul><li>?Lymphoma </li></ul><ul><li>?? rhabdomyosarcoma </li></ul>
  21. 21. Eye mass_ proptosis <ul><li>Heterogenous enhanced mass filling retrobulbar region, deforming eye ball? Malignant mass </li></ul>
  22. 22. Extra orbital lesions <ul><li>Lesions can cause proptosis if from </li></ul><ul><li>paranasal sinus/ nasal cavity or </li></ul><ul><li>intracranial mass extension or </li></ul><ul><li>bones in surrounding </li></ul>
  23. 23. Proptosis _ post. op case <ul><li>Intracranial mass/ </li></ul><ul><li>abscess with bone destruction </li></ul><ul><li>Check next slice </li></ul>
  24. 24. Same case <ul><li>Extracerebral mass/abscess drainage done </li></ul><ul><li>aggressive infection </li></ul><ul><li>gone deep </li></ul>
  25. 25. Proptosis <ul><li>Calcific density mass Rt. Retrobulbar pushing eye ball anteriorly </li></ul><ul><li>? Congenital bony Dysplasia </li></ul>
  26. 26. Proptosis <ul><li>Extra orbital midline malignant mass from base of skull </li></ul>
  27. 27. Paranasal sinus <ul><li>Nonenhanced expansile cystic </li></ul><ul><li>mass lesion in Rt. </li></ul><ul><li>frontal sinus </li></ul><ul><li>? mucocele </li></ul>
  28. 28. Paranasal sinus <ul><li>Nonenhanced expansile cystic mass lesion in Rt. </li></ul><ul><li>frontal sinus </li></ul><ul><li>? mucocele </li></ul>
  29. 29. Paranasal sinus <ul><li>Frontal mucocele </li></ul>
  30. 30. Paranasal sinus <ul><li>Huge soft tissue mass displacing </li></ul><ul><li>and compressing eye ball ? </li></ul><ul><li>ethmoidal mucocele </li></ul>
  31. 31. Paranasal Sinus <ul><li>Ethmoidal mucocele </li></ul>
  32. 32. Paranasal sinus <ul><li>Nonenhanced expansile </li></ul><ul><li>cystic lesion in sphenoidal sinus </li></ul><ul><li>?mucocele </li></ul><ul><li>might cause proptosis if huge </li></ul>
  33. 33. Paranasal sinus_ mass <ul><li>Paranasal sinus mass extending orbital fossa </li></ul>
  34. 34. Other paranasal sinus lesion <ul><li>Few paranasal sinus lesions might cause </li></ul><ul><li>eye problem or proptosis if the lesion is severe </li></ul>
  35. 35. Paranasal sinuses <ul><li>Thin wall enhanced lobulated cystic mass in both maxillary sinuses </li></ul><ul><li>? Mucosal cyst </li></ul>
  36. 36. Paranasal sinuses <ul><li>Air fluid level in Rt. Maxillary sinus </li></ul><ul><li>? sinusitis </li></ul>
  37. 37. Paranasal sinuses <ul><li>Irregular mucosal thickening Lt. </li></ul><ul><li>maxillary sinus </li></ul><ul><li>Calcified mucosa Rt. Maxillary sinus </li></ul><ul><li>? Chronic sinusitis </li></ul>
  38. 38. Mass face <ul><li>Mass Rt maxillary antrum, filling nasal cavity, crossing midline </li></ul><ul><li>? malignancy </li></ul>
  39. 39. Mass face <ul><li>Advance </li></ul><ul><li>malignancy </li></ul><ul><li>Rt. maxillary </li></ul><ul><li>antrum </li></ul>
  40. 40. Intracranial mass <ul><li>well enhanced </li></ul><ul><li>suprasellar mass </li></ul><ul><li>involving Rt. Optic </li></ul><ul><li>nerve? </li></ul><ul><li>meningioma </li></ul>
  41. 41. Same case <ul><li>Huge mass </li></ul><ul><li>with </li></ul><ul><li>hydrocephalus </li></ul>
  42. 42. AVM <ul><li>dilated sup. Ophth.vein </li></ul>

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