RADIOLOGICAL
ANATOMY OF ORBIT
Walls of the Orbit
The bony orbit is a pyramidal shaped
structure
Normal volume in an adult -30 cc of
which the globe occupies 6.5 cc
IMAGING RECOMMENDATIONS
Radiography : used to look for fractures of the
orbital wall or screen for any foreign bodies before
undergoing MRI
Occipitomental/ Water’s view
Occipito-Mental / Water’s view
CT imaging of orbit
CT imaging of orbit is preferred incase
of orbital trauma , for delineating
osseous structures, calcified lesions
and when MRI is contraindicated.
Shorter imaging time , less motion
artifacts- hence ideal for imaging orbital
trauma.
In dedicated orbital CT protocol <1.5mm
thin sections are acquired.
Axial plane – parallel to orbital long axis
(infraorbital-meatal line )
Coronal- in the plane perpendicular to
axial plane
Parasagittal- in the plane parallel to long
axis of optic nerve
Contrast – evaluation of
inflammatory,neoplastic and vascular
orbital diseases
Orbital varix
MRI protocol
Should include T1 and T2-weighted
imaging in axial ,coronal and sagittal
planes.
Orbital MRI is susceptible to imaging
artifacts like chemical shift
artifacts,susceptibility , motion artifacts
Coronal CT : Bony orbits at mid anterior
level and at the level of orbital apex
CT Orbit Bone window Axial
view
CT bone window axial
view
CT bone window Axial and Coronal views
CT bone window coronal
view
Optic canal
Superior orbital
fissure
Inferior orbital
fissure
Spaces of the orbit
CT soft-tissue window axial view
CT soft tissue window parasagittal
view
CT soft tissue window
coronal
CT axial view soft tissue window
CT soft tissue window
Orbital muscles
orbital structures as seen from above
CT soft tissue window axial
view
MRI T1W axial
view
A-optic nerve in optic
canal
B- optic nerve sheath
complex
C - MR
D- ant chamber
E- lens
F- lid
G- medial and lateral
aspects of orbital
septum
H- LR
Coronal view
MRI T1W coronal view
MRI T1W CORONAL VIEW
Coronal post-
Gad T1W MRI
study
A- SR /LPS COMPLEX
B- Superior ophthalmic
vein
C-Optic nerve
D- lateral rectus
E-Dural sheath
F- Inferior rectus
G- Medial rectus
H- Superior oblique
Ophthalmic artery
MRI T1W CORONAL VIEW
MRI T1W axial view
MRI T1W sagittal view
Orbit
OPTIC NERVE
Optic nerve on axial T2W MRI
study
Axial T2W MRI study
IMAGING RECOMMENDATIONS
Ultrasound: first line modality for
intraocular lesions. Because of the
superficial location of eye , linear high-
frequency (7.5-13 MHz) transducers is
used.
In B-mode , the gain setting is first
adjusted for superficial images (anterior
chamber) and then for deeper(vitreous
and posterior wall)
Sonography of eye
Transducer pressure should be reduced to avoid
collapse of the anterior chamber
USG is contraindicated in patients with traumatic
eye injuries and suspected rupture
B-scan Axial
Eye in primary gaze
Probe centered on the cornea
Probe marker – nasal or temporal
The resulting image includes lens and is
bisected by optic nerve
Done to rule out lesion in relation to lens
and optic nerve
B-scan Transverse
probe oriented parallel to the limbus on
the opposite conjunctival surface .
Probe marker superior (if examining
nasal or temporal ) or nasal(if examining
superior and inferior)
6 clock hours examined at a time
Longitudinal B-scan
Probe kept perpendicular to the limbus
on the conjunctival surface overlying the
sclera and directed through the vitreous
bypassing the lens
Probe marker directed towards the
limbus or towards the area of interest
regardless of the clock hour to be
examined
Ultrasound of orbit – B
scan
Ultrasound of orbit – B
scan
Doppler of CRA and CRV in
healthy individual
A-scan(Amplitude modulation )
STIR vs SPIR (MRI imaging techniques)
STIR-Short Tau Inversion Recovery
SPIR-Spectral Presaturation with Inversion
Recovery
Both are done for fat suppression to prevent
obscuration of enhancing lesions by high
intraorbital fat.
SPIR selectively suppresses fat signal by
targeting its specific resonance frequency,
whereas STIR suppresses fat along with
other tissues
MRI T1W axial views
THANK YOU