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MRI artifact masquerading as orbital disease
B A Brown1, C E Swallow, A S Eiseman
1Ophthalmology Service, Walter Reed Army Medical Center, Washington DC, USA.
Objectives:
To describe the diagnostic challenge associated with magnetic resonance imaging (MRI) artifact and to describe methods of minimizing this artifact.
Methods:
Gadolinium enhancement was demonstrated to be artifact by using an inversion recovery pulse sequence technique.
Results:
A patient with complaints of painless loss of vision also had radiologic abnormalities that led to subsequent referral to a tertiary care facility. Increased signals on the fat-suppressed contrast enhanced MRI was demonstrated to be artifact by using an inversion recovery technique which produced a normal MRI of the orbit.
Conclusions:
Clinical confusion leading to unnecessary and costly evaluation may be avoided if one considers the possibility of artifact when reviewing magnetic resonance studies. When magnetic susceptibility is suspected, the use of an inversion recovery sequence can better delineate the true nature of the abnormality.
Insights
Magnetic resonance imaging (MRI) artifact can mimic real abnormalities, leading to misdiagnosis. An inversion recovery technique can help distinguish artifact from true findings, preventing unnecessary patient evaluations.
Area of Science:
- Radiology
- Medical Imaging
- Neuro-ophthalmology
Background:
- Magnetic resonance imaging (MRI) is a crucial diagnostic tool in medicine.
- Artifacts in MRI can complicate interpretation and lead to diagnostic challenges.
- Distinguishing true pathology from artifact is essential for accurate diagnosis and patient management.
Observation:
- A patient presented with vision loss and concerning MRI findings.
- Fat-suppressed, contrast-enhanced MRI showed increased signals suggestive of pathology.
- These findings were investigated further due to clinical suspicion.
Findings:
- The increased signals on the MRI were identified as artifact, not true pathology.
- An inversion recovery pulse sequence technique was employed to demonstrate the artifact.
- This technique successfully differentiated the artifact, leading to a normal MRI interpretation of the orbit.
Implications:
- Recognizing and identifying MRI artifact is critical to avoid clinical confusion.
- Failure to identify artifact can result in unnecessary, costly, and invasive patient evaluations.
- Utilizing specific techniques like inversion recovery can improve diagnostic accuracy when magnetic susceptibility artifact is suspected.
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