CREATION AND APPLICATION OF A REFERENCE VALUE FOR CINE MODE MAGNETIC REFERENCE IMAGING FOR DETERMINING SURGICAL INDICATIONS IN PATIENTS WITH AN OLD BLOW-OUT FRACTURE

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  • MARUYAMA Naoki
    Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital
  • SUMIYA Noriyoshi
    Department of Plastic and Reconstructive Surgery, Showa University Fujigaoka Hospital

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  • 陳旧性眼窩骨折患者に対する手術適応の決定に用いる眼窩シネモードMRIの基準値作成とその応用
  • チンキュウ セイガンカコッセツ カンジャ ニ タイスル シュジュツ テキオウ ノ ケッテイ ニ モチイル ガンカシネモード MRI ノ キジュンチ サクセイ ト ソノ オウヨウ

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Abstract

Persistent double vision is one of the most difficult symptoms for both patients and surgeons to deal with. This type of diplopia can be caused by ocular movement abnormalities resulting from adhesion, external opthalmoplegia, and damaged extraocular muscles. Therefore, it is essential to ascertain the underlying pathology of the orbit, both morphologically and functionally. We believe that cine magnetic resonance imaging (MRI) is the optimal diagnostic tool not only for determining the cause of ocular motility disturbance, but also to develop clinical strategies. Previous studies have indicated that cine MRI can provide abundant information on the general orbital structure and extraocular muscle function. We use cine MRI clinically to determine the cause of ocular motility disturbance after a blow-out fracture. However, to our knowledge, no reports clearly describeg how to interpret cine MRI in such cases. Here, we introduce a reference value to aid with interpretation and describe the technological aspects of utilizing sagittal, horizontal and coronal sections. We created the reference value from cine MRI images acquired from 40 healthy volunteers (80 orbits). Seven images were obtained per section per person (total 1400 images), using a General Electric Signa, 1.5 Tesla, superconducting MRI scanner and these images were converted to cine MRI images. We measured the length and thickness of the external eye muscles from the images and calculated the contraction rate, extension rate, and other parameters. We present the use of cine MRI in a complex clinical case to illustrate the diagnostic utility of this modality.

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