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Teaching Points
Teaching Points
- Helical CT scanning is considered diagnostic method of choice for the detection of intraocular and orbital metallic, glass and stone foreign bodies and is preferred over MR imaging and sonography.
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Investigation of Suspected Orbital Foreign Body: Computed Tomography
- Helical CT axial scanning with multiplanar reconstruction is accurate at detecting and localizing intraocular and orbital metallic, glass and stone foreign bodies 1-5
- Helical CT scanning is considered the diagnostic method of choice for the detection of intraocular foreign bodies and is preferred over both MR imaging and sonography 1,2,4,6,7
- In their study on porcine eye model to look at the efficacy of different imaging modalities for detecting various types of glass fragment subtype, location, and size, Gor et al showed that the helical CT was the most sensitive imaging modality for the detection of intraocular glass. 8 Green beer bottle glass was easiest to detect, and spectacle glass was the most difficult. On helical CT, glass fragments were easier to detect in the anterior chamber, and most difficult on the corneal surface
- McGuckin, in their in vitro model, concluded that CT was the preferred imaging modality for wooden foreign bodies 6
- It is critical to detect wood as organic foreign bodies can lead to a number of complications including cellulitis, abscess and increased mortality when compared with metallic foreign body which are relatively well tolerated 9
References
References
References are graded from Level I to V according to the Oxford Centre for Evidence-Based Medicine, Levels of Evidence. Download the document
- Lakits A, Steiner E, Scholda C, Kontrus M. Evaluation of intraocular foreign bodies by spiral computed tomography and multiplanar reconstruction. Ophthalmology. 1998;105(2):307-12. (Level III evidence)
- Lakits A, Prokesch R, Scholda C, Bankier A. Orbital helical computed tomography in the diagnosis and management of eye trauma. Ophthalmology. 1999;106(12):2330-5. (Level II evidence) View the reference
- Chacko J, Figueroa R, Johnson M, Marcus D, Brooks S. Detection and localization of steel intraocular foreign bodies using computed tomography. A comparison of helical and conventional axial scanning. Ophthalmology. 1997;104(2):319-23. (Level II evidence) View the reference
- Lindahl S. Computed tomography of intraorbital foreign bodies. Acta Radiol. 1987;28(3):235-40. (Level III evidence)
- Prokesch R, Lakits A, Scholda C, Bankier A, Ba-Ssalamah A, Imhof H. Spiral CT and conventional CT in the preoperative imaging of intraocular metal foreign bodies. Radiology. 1998;38(8):667-73. (Level II evidence)
- McGuckin Jr J, Akhtar N, Ho V, Smergel E, Kubacki E, Villafana T. CT and MR evaluation of a wooden foreign body in an in vitro model of the orbit. Am J Neuroradiol. 1996;17(1):129-33. (Level III evidence)
- McNicholas MM, Brophy DP, Power WJ, Griffin JF. Ocular trauma: evaluation with US. Radiology. 1995;195(2):423-7. (Level II evidence) View the reference
- Gor DM, Kirsch CF, Leen J, Turbin R, Von Hagen S.Radiologic differentiation of intraocular glass: evaluation of imaging techniques, glass types, size, and effect of intraocular hemorrhage. AJR Am J Roentgenol. 2001;177(5):1199-203. (Level III evidence)
- Go JL, Vu VN, Lee KJ, Becker TS. Orbital trauma. Neuroimag Clin N Am. 2002;12(2):311- 24. ( Level III evidence)
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