EURORAD ESR

Case 2846

A multirow CT evaluation in a case of orbital decompression

Author(s)
Cappelli C, Torri P, Pratali A, Vagli P, Mazzeo S.
 
Patient
female, 43 year(s)
 
 
  • Figure 1
    A CT examination before the surgical decompression: bilateral severe proptosis and thickening of...
     

    A CT axial scan showing a bilateral severe proptosis (distance from the bizigomatic line 29--30 mm).

     
    Area of Interest: unknown; Imaging Technique: CT examination before the surgical decompression: bilateral severe proptosis and thickening of extrinsic oculomotor muscles.;

    A CT scan on the coronal plane showing a thickening of both superior straight muscles (right: 8 mm; left: 10 mm).

     
    Area of Interest: unknown; Imaging Technique: CT examination before the surgical decompression: bilateral severe proptosis and thickening of extrinsic oculomotor muscles.;

    Both the medial straight muscles, measured in the coronal and axial planes, result to be hypertrophic (right: 12 mm; left: 11 mm). The normal values of lateral and medial straight muscles are less than 4 mm.

     
    Area of Interest: unknown; Imaging Technique: CT examination before the surgical decompression: bilateral severe proptosis and thickening of extrinsic oculomotor muscles.;
     
     
  • Figure 2
    A CT examination before the surgical decompression: optic nerves compression
     

    A coronal planes reveal the absence of a fatty plane between the medial straight muscles and the medial portion of both the optic nerves; this finding represents an initial sign of compression.

     
    Area of Interest: unknown; Imaging Technique: CT examination before the surgical decompression: optic nerves compression.;

    An MPR reformation on an axial plane allows to visualize the entire course of both the optic nerves and to confirm the initial compression from the hypertrophic medial straight muscles.

     
    Area of Interest: unknown; Imaging Technique: CT examination before the surgical decompression: optic nerves compression.;
     
     
  • Figure 3
    Volume rendering evaluation of bony orbital walls before and after surgical decompression.
     

    Volume rendering reconstructions showing the superior and the posterior bony orbital walls before (upper image) and after (lower image) the surgical decompression.

     
    Area of Interest: unknown; Imaging Technique: Volume rendering evaluation of bony orbital walls before and after surgical decompression.;

    Volume rendering reconstructions showing the lateral (greater wing of the sphenoid bone and orbitalis processus of the zygomatic bone) bony orbital walls before (upper images) and after (lower images) the surgical...

     
    Area of Interest: unknown; Imaging Technique: Volume rendering evaluation of bony orbital walls before and after surgical decompression.;
     
     
  • Figure 4
    A CT examination after the surgical decompression
     

    The coronal images showing the reappearance of the fatty cleavage between the medial straight muscles and the medial portion of the nerves.

     
    Area of Interest: unknown; Imaging Technique: CT examination after the surgical decompression.;

    An MPR reformation reveals the disappearance of nervous compression at the level of the orbital apex.

     
    Area of Interest: unknown; Imaging Technique: CT examination after the surgical decompression.;

    The axial CT scans taken before (left) and after (right) a surgical decompression. After the decompression, both the medial straight muscles resulted in an increased thickness because of the retraction of the...

     
    Area of Interest: unknown; Imaging Technique: CT examination after the surgical decompression.;
     
     
A CT axial scan showing a bilateral severe proptosis (distance from the bizigomatic line 29--30 mm).
 
A CT scan on the coronal plane showing a thickening of both superior straight muscles (right: 8 mm; left: 10 mm).
 
Both the medial straight muscles, measured in the coronal and axial planes, result to be hypertrophic (right: 12 mm; left: 11 mm). The normal values of lateral and medial straight muscles are less than 4 mm.
 
A coronal planes reveal the absence of a fatty plane between the medial straight muscles and the medial portion of both the optic nerves; this finding represents an initial sign of compression.
 
An MPR reformation on an axial plane allows to visualize the entire course of both the optic nerves and to confirm the initial compression from the hypertrophic medial straight muscles.
 
Volume rendering reconstructions showing the superior and the posterior bony orbital walls before (upper image) and after (lower image) the surgical decompression.
 
Volume rendering reconstructions showing the lateral (greater wing of the sphenoid bone and orbitalis processus of the zygomatic bone) bony orbital walls before (upper images) and after (lower images) the surgical decompression.
 
The coronal images showing the reappearance of the fatty cleavage between the medial straight muscles and the medial portion of the nerves.
 
An MPR reformation reveals the disappearance of nervous compression at the level of the orbital apex.
 
The axial CT scans taken before (left) and after (right) a surgical decompression. After the decompression, both the medial straight muscles resulted in an increased thickness because of the retraction of the intraorbital structures and both optic nerves showed a mild scoliotic course.
 
 
 
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