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Papilloedema (MRI)

Case contributed by: Dr Frank Gaillard

From the case: Papilloedema (MRI)

Modality: MRI

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T2WI

Case Discussion:

Axial fast spin echo (FSE) T2WI of the right orbit demonstrates high T2 signal expanding the dural sheath of the optic nerve. As most standard brain MR studies will have only axial T2 images, which are usually non-contiguous (i.e have a skip between slices), the optic nerve will not always be captured in an image. Coronal images are often helpful, (e.g coronal T1WI of same patient - see below) demonstrating a cuff of CSF signal surrounding the optic nerve.

Note however that with the advent of motion correction (e.g. BLADE) sequences, CSF in the dural sheath over the optic nerve is much more frequently seen, and caution should be shown when reporting this. Flattening of bulging of the optic nerve head, is probably a more specific sign.