Imaging of orbital infectious and inflammatory disease in children

Nagaraj, Usha D.; Koch, Bernadette L.

doi:10.1007/s00247-020-04745-7

Cited by 15 publications

(13 citation statements)

References 70 publications

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“…In the evaluation of a case of periorbital cellulitis, ultrasound is an excellent modality to delineate any drainable liquefied abscesses. 3 In case of vascular malformations, ultrasound can show their cystic nature and help characterise them into slow-or high-flow lesions on the basis of their vascularity. Retro-orbital deep-seated lesions causing proptosis are not amenable to clinical or ophthalmic evaluation.…”

Section: Clinical Problems and Usesmentioning

confidence: 99%

“…Ultrasound is also beneficial in diagnosing various orbital pathologies. In the evaluation of a case of periorbital cellulitis, ultrasound is an excellent modality to delineate any drainable liquefied abscesses 3 . In case of vascular malformations, ultrasound can show their cystic nature and help characterise them into slow‐ or high‐flow lesions on the basis of their vascularity.…”

Section: Clinical Problems and Usesmentioning

confidence: 99%

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Paediatric orbital ultrasound: Tips and tricks

Gupta

Arora

Seth

et al. 2022

Australas J Ultrason Med

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Background The orbital structures are ideally suited for ultrasound examination due to their superficial location and cystic composition of the eye. However, orbital ultrasound remains an underutilised modality due to preference for other cross‐sectional modalities in general practice. Aim In this article, we review the basic principles, clinical uses and technique of orbital ultrasound in peadiatric patients. Materials and methods The clinical utility of orbital ultrasound in peadiatric patients is demonstrated using selected cases. Results Ultrasound is useful in the diagnosis of various posterior segment pathologies, especially in conditions causing opacification of light‐conducting media of the eye. It is also beneficial in diagnosing various orbital pathologies, particularly in differentiating solid from cystic lesions. Discussion The added advantages of its use in children include lack of ionising radiation and reduced requirement of sedation or general anesthesia. Ultrasound is the most practical initial investigation in cases where ophthalmoscopy is limited by opacification of ocular media. The addition of color Doppler on ultrasound can give additional information about the vascularity of the lesion. Conclusion Use of ultrasound can be streamlined into the workup of various orbital and ocular pathologies either as an initial investigation or as a problem‐solving tool in cases with a diagnostic dilemma on other modalities.

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Section: Clinical Problems and Usesmentioning

confidence: 99%

Section: Clinical Problems and Usesmentioning

confidence: 99%

Paediatric orbital ultrasound: Tips and tricks

Gupta

Arora

Seth

et al. 2022

Australas J Ultrason Med

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“…3,5,7,8 Inflammatory diseases, such as subperiosteal abscesses or epidural abscesses in the intraorbital region, may also progress if adequate treatment is not administered. [9][10][11][12][13] This progression can result in vision loss. Therefore, diagnosis and evaluation of these lesions are important for selecting the appropriate treatment modality.…”

mentioning

confidence: 99%

“…Therefore, diagnosis and evaluation of these lesions are important for selecting the appropriate treatment modality. 7,9,10,14 Computed tomography (CT) and magnetic resonance imaging (MRI) are the imaging techniques commonly used for diagnosis of intra-orbital lesions. [1][2][3][4][5]7,12,13,15 Despite the radiation exposure, CT can be rapidly performed in emergency situations without the need for considering foreign bodies.…”

mentioning

confidence: 99%

“…1,2,10,16 Although MRI requires sedation and the need to care for metal artifacts, it provides high-resolution soft tissue images and anatomical information, including those of the optic nerve and epidural space. 1,2,10 In addition to these modalities, ultrasound has been reported to be useful for evaluating extraocular intra-orbital lesions. 8,9,14,17,18 However, no study has focused on intra-orbital lesions that are difficult to evaluate using ultrasonography techniques.…”

mentioning

confidence: 99%

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Assessing the Usefulness of Ultrasonography for the Diagnosis and Evaluation of Intra‐Orbital Lesions in Pediatric Patients

Hosokawa,

Kuntaro,

Takei

et al. 2023

J of Ultrasound Medicine

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ObjectivesTo assess the usefulness of ultrasonography in the diagnosis and evaluation of extraocular intra‐orbital lesions in pediatric patients.MethodsTwenty‐three pediatric patients with intra‐orbital lesions who underwent both ultrasound and computed tomography/magnetic resonance imaging (CT/MRI) were included. The following parameters were evaluated using ultrasound: 1) lesion detection rate (presence or absence of lesions), 2) lesion characteristics, 3) lesion location (extraconal or intraconal), and 4) the lesion longest linear dimensions, and these were compared using Fisher's exact test and Mann–Whitney U test.ResultsTwo lesions could not be detected using ultrasound; in the other 21 cases, the lesion characteristics diagnosed by ultrasound were correct. Diagnostic accuracy of detection and characteristics assessment using ultrasound were 91.3% and 91.3%, respectively. The lesion location was not significantly different between the two groups (intraconal/extraconal in those detected using ultrasound versus those in the absence on ultrasound = 7/14 versus 0/2, P > .999); however, in two cases that were not detected on ultrasound, the lesions were located at extraconal. Lesions that were small in longest linear dimensions on CT/MRI were not detected using ultrasound (the longest linear dimensions in lesions detected using ultrasound versus that in the absence of ultrasound: 29.5 ± 8.2 [range, 13–46] versus 10 and 11 mm, P = .043).ConclusionsUltrasonography proved to be useful for visualizing and evaluating intra‐orbital lesions except for lesions that were relatively small in size. Therefore, although ultrasound could not detect lesions located behind bone and bone invasion, it could be used for diagnosing and selecting treatment strategies for intra‐orbital lesions.

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