Evaluation of reconstructed orbital wall fractures: high-resolution MRI using a microscopy surface coil versus...

We evaluated high-resolution magnetic resonance imaging (MR) using a 47-mm microscopy surface coil in comparison to 16-slice multislice CT (MSCT) for postsurgical imaging of reconstructed orbital walls. Twenty-five patients with 27 internal orbital wall fractures were imaged prospectively after reconstruction with resorbable polydioxanone sulfate (PDS) sheets. Coronal high-quality T1- and T2-weighted MR images were obtained with an in-plane resolution of 350 microm within a measure time of 6-7 min for each sequence. Nineteen symptomatic patients underwent MSCT as the current gold standard. In MRI the PDS foil appears in T1- and T2-weighted images as a thin, low-signal-intensity linear structure. In CT it appears hyperdense in comparison to soft tissue and slightly hypodense in comparison to cortical bone. PDS foils could be clearly depicted in 20 out of 25 patients (80%) with MRI and in 13 out of 19 patients (68%) with MSCT. An inadequate foil position or size could be diagnosed in eight patients with MRI and in only three patients with MSCT. In ten symptomatic patients secondary surgery could be avoided because of regular MRI findings except mild hematoma and muscle edema. High-resolution MRI of the orbit using a 47-mm microscopy coil is a promising method to accurately demonstrate normal and pathologic conditions in symptomatic patients after orbital wall reconstruction with PDS foils.