Demystifying Orbital Emergencies: A Pictorial Review

Nguyen, Viet Long; Singh, Achint K.; Altmeyer, Wilson; Tantiwongkosi, Bundhit

doi:10.1148/rg.2017160119

Cited by 70 publications

(42 citation statements)

References 45 publications

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“…Ultrasonography is another alternative imaging method to diagnose inflammation or tumors of the globe in selected cases, but the technique is operator dependent and shows limited capacity in the evaluation of the retrobulbar structures [ 12 , 13 ].…”

Section: Imaging Protocolsmentioning

confidence: 99%

CT and MR imaging of orbital inflammation

et al. 2018

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PurposeOrbital inflammation can be idiopathic or in the context of a specific disease and it can involve different anatomical orbital structures. On imaging, inflammatory disease is frequently mistaken for infection and malignant tumors, and its underlying cause is often not determined. Through this article we aim to improve orbital inflammation diagnosis and underlying inflammatory diseases recognition.MethodsThe imaging protocols and characteristics of orbital inflammation were reviewed.ResultsA decision tree for the evaluation of these patients is provided. First, a combination of clinical and radiological clues is used to recognize inflammation, in particular to differentiate it both from orbital infection and tumor. Subsequently, different radiological patterns are recognized, often allowing the differentiation of the several orbital inflammatory diseases.ConclusionThe use of adequate imaging protocols and subsequent evaluation allow the recognition of an orbital lesion as inflammatory and the diagnosis of the underlying inflammatory disease. All in all, a proper treatment can be established, and at times, a biopsy can be avoided.

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Section: Imaging Protocolsmentioning

confidence: 99%

CT and MR imaging of orbital inflammation

et al. 2018

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“…Lastly, a full paper review of all eight of the selected articles was performed, which led to the selection of five articles to be utilized in the final review. [2][3][4][5][6] Of the orbital CT evaluation approaches, the BALPINE method was determined to be the simplest to implement, while still being comprehensive. 7,8 To test the effectiveness of the CT evaluation method, an examination composed of CT orbital images was developed with the aid of the Ophthalmology and Radiology departments at San Antonio Uniformed Services Health Education Consortium (SAUSHEC).…”

Section: Methodsmentioning

confidence: 99%

“…Since 1985, efforts have been made through studies and publications to create a systematic approach for ophthalmologists to use when evaluating CT scans. [2][3][4][5][6] One study showed that various CT findings could be used to predict treatment and surgical management of orbital injuries. 7 Despite these efforts, no approach has been widely adopted by ophthalmologists or used to teach residents.…”

mentioning

confidence: 99%

A Systematic Approach to Orbital CT Scans: Integrating the BALPINE Method into Ophthalmology Curriculum

Nelson

Reed

Justin

et al. 2020

Journal of Academic Ophthalmology

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Abstract Objective While multiple approaches to the evaluation of orbital computed tomography (CT) imaging have been proposed in both ophthalmology and radiology literature, there remains a paucity of standardized approaches to orbital CT interpretation education for the ophthalmologist in training. To address this, the bones, anterior chamber, lens, posterior globe, intraconal orbit, neurovascular structures, and extraocular muscles (BALPINE) method was selected and its utilization tested as an education tool to improve resident competency in the proper assessment of orbital CT imaging. Methods The BALPINE method is an established systematic approach to reading orbital CT scans. This approach was selected as a standardized education tool after a systematic review of orbital CT evaluation methods in the ophthalmology and radiology literature. A 15-item test, comprised of frequently diagnosed orbital pathologies developed in conjunction with a radiologist, was designed to test a group of ophthalmologists in training across multiple residency programs. The in-training ophthalmologists were first given this test prior to being taught the BALPINE standardized method to assess orbital CT imaging. The study participants were then administered a lecture describing the BALPINE method approach to orbital CT imaging. The same study participants were then administered the same test to assess improvement. The lecture was developed and administered by a board-certified Oculoplastic surgeon. The lecturer was blinded to the images included in the examination during lecture development. The radiologist was blinded to the lecture and the BALPINE method; thus, the images selected were not specific to the method being taught. Results Overall, 27 residents, interns, and medical students completed the prelecture test, BALPINE method curriculum lecture, and postlecture test. There was an average of a 2.3-point (15%) significant improvement per test score (p < 0.0001). Each level of training demonstrated improvement pre- and posttest and overall scores improved with each additional year of training, indicating the test was an appropriate measurement of ability and understanding. Conclusion Teaching a systematic approach to the evaluation of orbital CT scans improves an ophthalmologist in training's ability to diagnose orbital pathology efficiently and effectively. Widespread residency curriculum adoption of the BALPINE method would enhance the training ophthalmologist's diagnostic capability.

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“…Intraorbital spread from ethmoid and frontal ARS is the most common complication and may present as cellulitis, subperiosteal or intraorbital phlegmon and abscess, and lateral displacement of the medial rectus muscle (Figure 6a and b). The clinical presentation may be forward protrusion of the eyeball, proptosis [8][9][10].…”

Section: Acute Rhinosinusitis and Complicationsmentioning

confidence: 99%

Imaging in Sinonasal Disorders

Eggesbø¹

2020

Dysfunction of Olfactory System [Working Title]

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Computed tomography (CT) is the "working horse" in sinonasal imaging and should always be the first choice. Magnetic resonance imaging (MRI) is complementary to CT when complications to rhinosinusitis or neoplasm are suspected. Imaging of the paranasal sinuses is common due to stuffy nose. In order to correct interpretation, proper imaging technique as well as knowledge of bony anatomy and variants and mucosal incidental findings are of outmost importance. Acute rhinosinusitis is very common and does not need imaging unless complications are suspected. In chronic rhinosinusitis, a CT examination is needed to find the cause and site of the mucociliary obstruction and to rule out other causes as odontogenic and fungal sinusitis and neoplasms.

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Demystifying Orbital Emergencies: A Pictorial Review

Cited by 70 publications

References 45 publications

CT and MR imaging of orbital inflammation

CT and MR imaging of orbital inflammation

A Systematic Approach to Orbital CT Scans: Integrating the BALPINE Method into Ophthalmology Curriculum

Imaging in Sinonasal Disorders

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