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Year :2018
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Month :
January-February
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Volume :
7
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Issue :
1
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Page :
RO33 - RO37
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Multidetector Computed Tomographic Evaluation of Proptosis
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Correspondence Address :
Naveen KG, T Arul Dasan, Boobathi Raja G, Vedaraju KS,
Dr. T Arul Dasan,
20, MCHS Colony, 5 C Cross, 16 Main, BTM Layout 2
Stage, Bengaluru-560076, Karnataka, India.
E-mail: arul_dsn@yahoo.co.in
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Introduction: Introduction: Forward protrusion of the eyeball with respect to the orbit is known as proptosis. There are various causes of proptosis, among which lesions within the orbit are the commonest while para-orbital lesions, like extension of cranial or sinus lesions into the orbit are less common. Causes of proptosis can be classified either anatomically or pathologically. The pathological classification is the most commonly followed and easier to comprehend.
Aim: To analyse the diagnostic role of CT-scan in evaluation of proptosis.
Materials and Methods: The study population comprised of 50 patients of various age groups and both sexes who were clinically diagnosed to have unilateral or bilateral proptosis and were referred to our department for imaging. After informed consent, they were subjected to plain CT-scan of both orbits. Further, intravenous contrast study was done wherever necessary and results were interpreted after reconstruction. CT findings were correlated with MRI, histopathological and intraoperative findings wherever feasible.
Results: Of the 50 cases, 38 patients had unilateral proptosis, while 12 patients had bilateral proptosis. Out of all, 23 (46%) were neoplastic, 12 (24%) were infective, 11 (22%) were inflammatory, 3 (6%) were traumatic and 1 (2%) were vascular in origin. Lymphoma was the most common orbital tumour observed in our study. Thyroid ophthalmopathy was the most common cause of bilateral proptosis. Overall, CT diagnosis was accurate in 80% of the cases.
Conclusion: CT’s ability to characterise a lesion based on density, calcification, and enhancement helps to formulate a differential diagnosis and decide further management. Knowing the precise location of the lesion in the orbit facilitates planning of an appropriate surgical approach. CT is also useful to demonstrate the extra orbital extension of the lesion. CT is ideal to detect bony erosion/expansion when present.In view of non specific findings in cases of some orbital tumours and in pseudotumours, a correlation with clinical and laboratory data is essential to arrive at a diagnosis.
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