Diagnostic value of three dimensional CT reconstruction in various orbital disorders
Journal Title: IP International Journal of Ocular Oncology and Oculoplasty - Year 2016, Vol 2, Issue 1
Abstract
Background: The diagnosis of orbital disease is an extremely challenging task. Technological advancement in computer software algorithms have allowed three dimensional (3D) reconstruction of complex orbital and craniofacial skeleton from 2D images. This study was undertaken to assess the diagnostic value of three-dimensional computed tomography (3D CT) in evaluating various orbital disorders. Materials and Methods: Over a five year period, 110 patients (69 males, 41 females) suffering from various orbital disorders were studied between January 2010 to February 2015 at our teaching hospital .After complete clinical examination, each patient was subjected to Multislice (64 slices) 2D CT. Post processing of the volume data so acquired was performed on an off-line workstation to generate multi-planner reconstructions along with maximum intensity projections (MIP) and volume rendered (VR) images wherever essential. Result: Out of 110 patients, 61.82% were male and 38.18% females, ranging in age from 3 months to 79 years. 60 (54.5%) had orbital trauma, 42 (38.18%) had orbital tumor (mass lesion) while rest (7.32%) were suffering from congenital orbital/ craniofacial abnormalities. Among the trauma cases, 12 (10.9%) had isolated orbital trauma, 28 cases (25.45%) had maxillofacial trauma and the rest 20 cases (18.18%) had cranio-orbital trauma. Among the neoplastic disorders, 22.73% had malignant lesions and rest 15.45% had benign lesions, out of them 4.55% were vascular lesion and 10.90% were developmental/ congenital mass. 7.27% had orbital bone dysostosis with craniofacial malformations. In all 110 patients, the 3D CT reformatted images confirmed the findings of conventional CT and radiographs and provided additional information regarding size, shape and extension of mass lesion or any fracture or bony erosion. It also provided depth perception and volumetric assessment. Conclusion: The present day multi-detector row CT scan offers the unique opportunity for evaluation of pathologies in multiple planes. The volume data generated is isotropic in nature and can generate images in any plane without anatomical distortion. The capability is of specific use in complex regions like orbit 3D where the reformatted projections not only remain a valuable problem solving tool but has become an essential pre-requisite for evidence based management. Further the 3D volume images remain of prime importance for a clinician to adequately counsel his patients and for post-operative evaluation of surgical results.
Authors and Affiliations
Virendra P. Singh, Mahendra K. Singh, Shrinkha Shrinkha
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