|T1 pre-gad||T1 post-gad with fat sat||T1 post-gad with fat sat|
Some things to consider when you see inflammatory changes in the intraconal fat include optic neuritis, lymphoma, Graves and pseudotumor. Involvement of the optic nerve is atypical for all of these except optic neuritis. Optic nerve glioma and meningioma may produce enhancement involving the optic nerve, but would not cause inflammation of the orbital fat. In addition to her visual problems, this patient also had some left sided weakness and cerebellar dysfunction on neurologic examination. In addition her brain MR showed a few periventricular white matter lesions which were perpendicular to the ventricles suggestive of MS. Her symptoms improved after steroid therapy. Related Cases
Jacobs L, Munschauer FE, Kaba SE. Clinical and magnetic resonance imaging in optic neuritis. Neurology Jan 1991; 41(1):p15-9.
Guy J, Mancuso A, Quisling RG, et al. Gadolinium-DTPA-enhanced magnetic resonance imaging in optic neuropathies. Ophthalmology May 1990; 97(5):p592-9.
Guy J, Mao J, Bidgood WD, et al. Enhancement and demyelination of the intraorbital optic nerve. Fat suppression magnetic resonance imaging. Ophthalmology May 1992; 99 (5):p713-9/
Mukherji SK, Tart RP, Fitzsimmons J, et al. Fat-suppressed MR of the orbit and cavernous sinus: comparison of fast spin-echo and conventional spin-echo. AJNR Oct 1994; 15(9):p1707-14.
|Orbital sarcoidosis||Optic nerve glioma||Orbital lymphoma|