ORBIT Imaging anatomy

Imaging Recommendations
Radiography

Ultrasound
• First line modality for intraocular lesions
• Noninvasive, readily available

CT & MR are complementary techniques; both are indicated

for evaluation of complex lesions

CT
• Excellent evaluation of orbit aided by natural contrast.
between fat, bone, air & soft tissues.
• Easily detects calcifications.
MR

• Optimal soft tissue contrast for globe, optic nerve, orbital

structures, and intracranial findings.

• Stronger gradients, faster sequences, surface coils, routine use

of fat suppression ± gadolinium improve image quality
 Radiography
WATERS PROJECTION

CM- canthomeatal line; CR- central ray.

(a, frontal sinus; b, medial orbital wall;
c, innominate line; d, inferior orbital rim;
e, orbital floor; f, maxillary antrum;
g, superior orbital fissure; h, zygomatic-frontal suture;
i, zygomatic arch)
 CALDWELL PROJECTION

a, frontal sinus;
b, innominate line;
c, inferior orbital rim;
d, posterior orbital floor;
e, superior orbital fissure; f, greater wing of sphenoid;
g, ethmoid sinus; h, medial orbital wall;
i, petrous ridge; j, zygomatic-frontal suture
 LATERAL PROJECTION

a, orbital roof;
b, frontal sinus;
c, ethmoid sinus;
d, anterior clinoid process;
e, sella turcica; f, planum sphenoidale
 BASAL PROJECTION (SUBMENTO-VERTEX)

a, zygomatic arch;
b, orbit;
c, lateral orbital wall;
d, posterior wall of maxillary sinus;
e, pterygoid plate; f, sphenoid sinus
 OPTIC FORAMEN (RHESE POSITION)

a, right optic canal;

b, optic strut;
c, superior orbital fissure;
d, ethmoid sinus;
e, planum sphenoidale;
f, greater wing of sphenoid
Sonography of eye
 B-scan probe orientations
1. Axial scan is obtained by placing the probe face directly over
the center of the cornea.
The resulting B-scan image includes the lens and is bisected
by the optic nerve.
 B-scan probe orientations
2. Longitudinal B-scan require the probe to be placed on the
conjunctiva overlying the sclera and directed through the
vitreous bypassing the lens.
It produce a cross-section of the eye along a specific clock
hour, displaying the anterior portion of the eye at the top of
the screen and the optic nerve at the bottom.
 Imaging protocols
CT
• Axial + coronal planes; thin-sections (~ 2 mm),Multislice acquisition
• Soft tissue algorithm
• Contrast for masses or inflammatory disease
• Noncontrast only when in conjunction with MR
Bones of the Orbit
Bones of the Orbit
AXIAL BONE CT
CORONAL BONE CT
MR
• Axial: Above orbital roof to orbital floor
• Coronal: Back of pons through globe
• Thin-section (3-4 mm); small FOV (12-16 cm)
• T1 pre-contrast (axial + coronal)
• STIR or T2 FSE fat-saturation (axial + coronal)
• T1C+ with fat-saturation (axial+coronal)

• Sagittal oblique for optic nerves

CORONAL T1 MR
OBLIQUE SAGITTAL T1 MR
Optic nerve-sheath complex
CORONAL &AXIAL STIR MR
GLOBE
THANK YOU