Imaging of the Orbit: “Current Concepts”

Abstract

Orbital imaging with CT or MRI can be essential in the evaluation of many orbital conditions. Because of its superior bony characterization and fast acquisition, CT is imaging method of first choice in urgent situations like trauma, infection, and evaluation of lesions arising from the orbital wall. Through recent years, CT has also gained a prominent role in (pre)operative planning and navigation, especially through the development of postprocessing software. For the evaluation of more complex orbital disease, MRI is the preferred modality. With its superior soft-tissue differentiation, MRI is useful for determining the extent of orbital lesions, like inflammatory disease, vascular malformations, and orbital tumors. By adding functional MRI techniques, like diffusion and perfusion-weighted imaging, and by combining parameters of different imaging techniques in multiparametric imaging, it is possible to further improve characterization of orbital lesions. In this chapter, the optimal approach to orbital imaging is described, combining knowledge of orbital imaging techniques and imaging indications, together with a structured way of reviewing the orbital images, knowledge of radiological features of common, and more uncommon orbital pathology, and integrating this with the clinical features of the patient.