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Neuroradiologie Scan 2015; 05(04): 311-328
DOI: 10.1055/s-0034-1392924
Fortbildung
© Georg Thieme Verlag KG Stuttgart · New York

Postoperative Bildgebung des Orbitainhalts[1]

Postoperative imaging of the orbital contents
Michael J. Reiter
,
Ryan B. Schwope
,
Jonathan A. Kini
,
Gerald E. York
,
Abraham W. Suhr
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Publication History

Publication Date:
22 September 2015 (online)

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Zusammenfassung

Die Ophthalmologen führen die verschiedensten Eingriffe am Inhalt der Augenhöhlen durch. Die chirurgische Behandlung von Glaukomen, Katarakten, Netzhautablösungen und Augentraumata oder -tumoren führt zu Veränderungen der Standardanatomie, die bei radiologischen Untersuchungen in vielen Fällen sofort ins Auge springen. Für den Radiologen ist die Fähigkeit, die verschiedenen Bildgebungsmanifestationen nach Augenoperationen richtig zu interpretieren, von entscheidender Bedeutung, wenn er Fehldiagnosen vermeiden will. Besonders wichtig ist, dass er mit den zahlreichen Arten von Implantaten vertraut ist, z. B. mit Glaukomfiltrationsimplantaten, Orbitaimplantaten und Lidgewichten. Kenntnisse der chirurgischen Anamnese des Patienten sind zwar hilfreich, doch liegen solche Informationen zum Zeitpunkt der Interpretation der Bildgebungsbefunde häufig nicht vor. Glücklicherweise gibt es charakteristische posttherapeutische Befunde, die eine Diagnose ermöglichen. Die Bildgebungsmerkmale der am häufigsten durchgeführten ophthalmologischen Eingriffe werden im vorliegenden Beitrag schlaglichtartig vorgestellt; der Schwerpunkt liegt dabei auf der CT und der MRT, da sie zurzeit die wichtigsten Modalitäten zur Beurteilung der Augenhöhlen sind. Glaukomfiltrationsimplantate und die nach einer Enukleation eingesetzten Orbitaimplantate sind 2 der in diesem Zusammenhang besonders interessierenden Objekte, weil ihre Zusammensetzung sich in den letzten 20 Jahren erheblich verändert hat – mit entsprechenden Auswirkungen auf die Bildgebung. Manche Implantate stören die radiologische Darstellung, so z. B. das Glaukomimplantat nach Baerveldt und die Lidgewichte aus Platin. Berichtet wird auch über die MRT-Sicherheitsprofile zahlreicher Implantate.

Abstract

Ophthalmologists perform a wide array of interventions on the orbital contents. The surgical treatment of glaucoma, cataracts, retinal detachment, and ocular trauma or malignancy results in alteration of the standard anatomy, which is often readily evident at radiologic examinations. The ability to accurately recognize the various imaging manifestations after orbital surgery is critical for radiologists to avoid misdiagnosis. Of particular importance is familiarity with the numerous types of implanted devices, such as glaucoma drainage devices, orbital implants, and eyelid weights. Although knowledge of patients’ surgical history is helpful, this information is often not available at the time of interpretation. Fortunately, there are characteristic posttreatment findings that enable diagnosis. The imaging features of the most commonly performed ophthalmologic procedures are highlighted, with emphasis on computed tomography and magnetic resonance (MR) imaging, because they are currently the primary modalities involved in evaluating the orbits. Glaucoma drainage devices and orbital implants after enucleation are two of the more pertinent implanted devices because their composition has substantially evolved over the past 2 decades, which affects their imaging appearance. Some devices, such as the Baerveldt Glaucoma Implant and platinum-weighted eyelid implants, may distort radiologic images. The MR imaging safety profiles of numerous implanted devices are also reported.

1 © 2015 The Radiological Society of North America. All rights reserved. Originally puplished in English in RadioGraphics 2015; 35: 221 – 234. Online published in 10.1148 /rg.351140008. Translated and reprinted with permission of RSNA. RSNA is not responsible for any inaccuracy or error arising from the translation from English to German.


 

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