Visibility of Different Intraorbital Foreign Bodies Using Plain Radiography,Computed Tomography,Magnetic Resonance Imaging,and Cone-Beam Computed Tomography: An in Vitro Study

Abstract

French

Purpose

The study sought to compare the usefulness of 4 imaging modalities in visualizing various intraorbital foreign bodies (IOFBs) in different sizes.

Methods

Six different materials including metal, wood, plastic, stone, glass. and graphite were cut in cylindrical shapes in 4 sizes (dimensions: 0.5, 1, 2, and 3 mm) and placed intraorbitally in the extraocular space of fresh sheep's head. Four skilled radiologists rated the visibility of the objects individually using plain radiography, spiral computed tomography (CT), magnetic resonance imaging (MRI), and cone-beam computed tomography (CBCT) in accordance with a previously described grading system.

Results

Excluding wood, all embedded foreign bodies were best visualized in CT and CBCT images with almost equal accuracies. Wood could only be detected using MRI, and then only when fragments were more than 2 mm in size. There were 3 false-positive MRI reports, suggesting air bubbles as wood IOFBs.

Conclusions

Because of lower cost and using less radiation in comparison with conventional CT, CBCT can be used as the initial imaging technique in cases with suspected IOFBs. Optimal imaging technique for wood IOFBs is yet to be defined.

Keywords

Intraorbital foreign body Radiography Computed tomography Magnetic resonance imaging Cone-beam computed tomography

Get full access to this article

View all access options for this article.

References

Bord

S.P.

Linden

Trauma to the globe and orbit

Emerg Med Clin North Am 2008; 26:97–123 vi–vii

Kubal

W.S.

Imaging of orbital trauma

Radiographics 2008; 28:1729–1739.

Tas

Top

Intraorbital wooden foreign body: clinical analysis of 32 cases, a 10-year experience

Ulus Travma Acil Cerrahi Derg 2014; 20:51–55.

Russell

D.J.

Kim

T.I.

Kubis

Evaluation and management of 2 ferocactus spines in the orbit

Ophthal Plast Reconstr Surg 2013; 29:e120–e123.

Santos Tde

Melo

A.R.

de Moraes

H.H.

Impacted foreign bodies in the maxillofacial region-diagnosis and treatment

J Craniofac Surg 2011; 22:1404–1408.

Williamson

T.H.

Smith

F.W.

Forrester

J.V.

Magnetic resonance imaging of intraocular foreign bodies

Br J Ophthalmol 1989; 73:555–558.

Boutin

R.D.

Briggs

J.E.

Williamson

M.R.

Injuries associated with MR imaging: survey of safety records and methods used to screen patients for metallic foreign bodies before imaging

AJR Am J Roentgenol 1994; 162:189–194.

Stuehmer

Essig

Bormann

K.H.

Majdani

Gellrich

N.C.

Rucker

Cone beam CT imaging of airgun injuries to the craniomaxillofacial region

Int J Oral Maxillofac Surg 2008; 37:903–906.

Dalili

Mahjoub

Sigaroudi

A.K.

Comparison between cone beam computed tomography and panoramic radiography in the assessment of the relationship between the mandibular canal and impacted class C mandibular third molars

Dent Res J (Isfahan) 2011; 8:203–210.

10.

Schnider

Reichart

P.A.

Bornstein

M.M.

Intraoral foreign bodies detected 40 years after a car accident using cone beam computed tomography

Quintessence Int 2012; 43:741–745.

11.

White

S.C.

Pharaoh

M.J.

Oral Radiology: Principles and Interpretation 6th ed. 2009

Mosby

St. Louis, MO

12.

De Vos

Casselman

Swennen

G.R.

Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature

Int J Oral Maxillofac Surg 2009; 38:609–625.

13.

Aras

M.H.

Miloglu

Barutcugil

Kantarci

Ozcan

Harorli

Comparison of the sensitivity for detecting foreign bodies among conventional plain radiography, computed tomography and ultrasonography

Dentomaxillofac Radiol 2010; 39:72–78.

14.

Pouriesa

Fouladi

R.F.

Mesbahi

Disproportion of end plates and the lumbar intervertebral disc herniation

Spine J 2013; 13:402–407.

15.

Lakits

Steiner

Scholda

Kontrus

Evaluation of intraocular foreign bodies by spiral computed tomography and multiplanar reconstruction

Ophthalmology 1998; 105:307–312.

16.

Deramo

V.A.

Shah

G.K.

Baumal

C.R.

Ultrasound biomicroscopy as a tool for detecting and localizing occult foreign bodies after ocular trauma

Ophthalmology 1999; 106:301–305.

17.

Stockmann

Vairaktaris

Fenner

Tudor

Neukam

F.W.

Nkenke

Conventional radiographs: are they still the standard in localization of projectiles?

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 104:e71–e75.

18.

Bray

L.C.

Griffiths

P.G.

The value of plain radiography in suspected intraocular foreign body

Eye (Lond) 1991; 5:751–754.

19.

de Santana Santos

Avelar

R.L.

Melo

A.R.

de Moraes

H.H.

Dourado

Current approach in the management of patients with foreign bodies in the maxillofacial region

J Oral Maxillofac Surg 2011; 69:2376–2382.

20.

Lagalla

Manfre

Caronia

Bencivinni

Duranti

Ponte

Plain film, CT and MRI sensibility in the evaluation of intraorbital foreign bodies in an in vitro model of the orbit and in pig eyes

Eur Radiol 2000; 10:1338–1341.

21.

Saeed

Cassidy

Malone

D.E.

Beatty

Plain X-ray and computed tomography of the orbit in cases and suspected cases of intraocular foreign body

Eye (Lond) 2008; 22:1373–1377.

22.

Holmes

P.J.

Miller

J.R.

Gutta

Louis

P.J.

Intraoperative imaging techniques: a guide to retrieval of foreign bodies

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100:614–618.

23.

Oikarinen

K.S.

Nieminen

T.M.

Makarainen

Pyhtinen

Visibility of foreign bodies in soft tissue in plain radiographs, computed tomography, magnetic resonance imaging, and ultrasound. An in vitro study

Int J Oral Maxillofac Surg 1993; 22:119–124.

24.

Imokawa

Tazawa

Sugiura

Oyake

Yosino

Penetrating neck injuries involving wooden foreign bodies: the role of MRI and the misinterpretation of CT images

Auris Nasus Larynx 2003; 30:S145–S147.

25.

Jones

J.C.

Ober

C.P.

Computed tomographic diagnosis of nongastrointestinal foreign bodies in dogs

J Am Anim Hosp Assoc 2007; 43:99–111.

26.

Adesanya

O.O.

Dawkins

D.M.

Intraorbital wooden foreign body (IOFB): mimicking air on CT

Emerg Radiol 2007; 14:45–49.

27.

Ober

C.P.

Jones

J.C.

Larson

M.M.

Lanz

O.I.

Werre

S.R.

Comparison of ultrasound, computed tomography, and magnetic resonance imaging in detection of acute wooden foreign bodies in the canine manus

Vet Radiol Ultrasound 2008; 49:411–418.

28.

Yamashita

Noguchi

Mihara

An intraorbital wooden foreign body: description of a case and a variety of CT appearances

Emerg Radiol 2007; 14:41–43.

29.

J.L.

V.N.

Lee

K.J.

Becker

T.S.

Orbital trauma

Neuroimaging Clin N Am 2002; 12:311–324.

30.

Zhu

Zhang

X.F.

Sheng

Y.J.

Combining diagnosis of IOFB and complications with multiple image-related methods

Zhonghua Yan Ke Za Zhi 2003; 39:520–523.

31.

Javadrashid

Fouladi

D.F.

Golamian

Visibility of different foreign bodies in the maxillofacial region using plain radiography, CT, MRI and ultrasonography: an in vitro study

Dentomaxillofac Radiol 44 2015 20140229

32.

Radiologists TRCo Making the Best Use of a Clinical Radiology 5th ed. 2003

Guidelines for Doctors

London, England