الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Orbital apex is exposed to various inflammatory, traumatic and neoplastic agents, these orbital apex pathologies affect the orbit and optic pathway causing orbital disorders.
The aim of this study was assessing the role of imaging in characterization of orbital lesions and helping to reach an accurate diagnosis. this study was carried out on 20 patients included 12 males and 8 females with wide age range from 5 months to 75 years. All patients were clinically presented with different orbital complaints where the commonest was blurred vision followed by diplopia and had referred to the department of radio-diagnosis and intervention for distinguish underlying orbital pathology. This referral followed initial assessment by ophthalmologists including full history taking, thorough clinical examination and laboratory investigations.
The acquisition imaging protocol was tailored according to the patient’s presentation and suspected diagnosis. In this study, 1 cases performed non-contrast CT study of orbit and brain, 9 cases were evaluated by contrast enhanced MRI of orbit and brain and 10 cases performed non-contrast CT and contrast enhanced MRI assessments of orbit and brain. MRI examination underwent in a closed 1.5 tesla Magnet with adherence to adequate technical parameters and as regard CT examination, it was performed on Siemens (64 slice) machine with reconstructed soft tissue and bone windows images.
As expected, neoplastic lesions represented the majority of cases about 13 cases against 7 non neoplastic lesions, followed by inflammatory causes accounting for 5 cases and trauma-related causes accounting for one case with only one case of mucocele.
At this study, the commonly encountered characteristic radiologic features, which helped in diagnosis of underlying orbital apex pathology, were presented as follows:
Optic glioma: fusiform enlargement of the optic nerve with the optic nerve not seen separable from tumor
Meningioma: extra-axial homogenously enhanced showed dural tail enhancement with sparing the optic nerve giving tram track appearance as well as related bony hyperostosis.
Lymphoma: Diffuse homogeneous T2 hypo-intense mass signal with mild homogeneous enhancement, lower ADC values than other malignant and dominant bony remodeling.
Nasopharyngeal carcinoma: Non-specific imaging findings, however aggressive bone destruction and soft tissue invasion were observed as common findings as well as the presence intra-tumoral necrosis may predict its diagnosis.
Juvenile angiofibroma: Young adult male with mass epicentered at the spheno- palatine foramen and the nasal cavity wall with bone remodeling and associated multiple signal voids.
Invasive fungal rhino-orbital sinusitis: Unilateral pattern with soft tissue thickening along the para-nasal sinus cavity walls associated with soft tissue infiltration and non-enhancing mucosa.
Chondrosarcoma: It is commonly associated with multiple stippled and amorphous areas of calcifications with associated related bone destruction and heterogeneous enhancement after contrast administration.