MR imaging of orbital blow-out fractures

We report on a case of orbital blow-out fractures involving the medial and inferior walls. In this case conventional multiplanar 8 mm thick sections with magnetic resonance (MR) imaging proved to be more helpful than 1.5 mm axial thin sections with CT in demonstrating the extent of orbital floor herniation of fat. Entrapment of muscle was excluded. Oblique sagittal views were most helpful in evaluating the orbital floor, since the full course of the inferior rectus muscle is seen. Additionally, the optic nerve is seen along its entire length. Masking of intraorbital contents by isodense hemorrhage on CT studies apparently is not a problem with MR imaging if hemorrhage is small or nonacute.