Papilloedema (MRI)

Case contributed by A.Prof Frank Gaillard
MRI

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.

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.

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Case information

rID: 2640
Case created: 7th May 2008
Last edited: 1st Oct 2015
Tag: mri
Inclusion in quiz mode: Included

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