Axial contrast-enhanced orbital CT demonstrates several features of a postseptal
infection (true orbital cellulitis). Note the subperiostial infiltrate and abscess, stranding
of the retrobulbar fat, lateral displacement of an enlarged medial rectus muscle, and
proptosis. The right ethmoid air cells are filled with an aggressive appearing
inflammatory disease. The individual bony septations appear destroyed and there
is erosion through the thin medial orbital wall (lamina papyracea).
Coronal CT also demonstrates involvement of the right frontal sinus.
After aggressive therapy, there is now some aeration of the ethmoid air cells, decreased
proptosis, and a decrease in size of the subperiostial abscess. The cribriform
plate remains intact and there is no apparent intracranial extension. However, there is
now involvement of the right maxillary sinus.
Continued postseptal enhancement demonstrated on T1-WIs after gadolinium and fat saturation.
Key words: mri infection inflammation fungus fungal orbit
sinus and orbit