Magnetic resonance imaging is a method of diagnostic examination of various human organs, combining the knowledge of nuclear physics and medicine. This method is just under 60 years old, but it began to be actively used only at the turn of the last and present centuries directly for the study of internal organs and the brain. A little later, the method gained great popularity in ophthalmology for diagnosing eye diseases, the cause of which is not visible during visual examination. MRI of the orbits and optic nerves allows you to detect the slightest changes in various tissues and structures of the eye that affect a person’s ability to see. This means that this method helps to identify the disease in its initial stage and begin treatment when it is most effective.

, , , , , , , , ,

Indications

Magnetic resonance imaging is considered one of the safest and most effective ways to identify various eye pathologies by carefully examining internal structures that are invisible to the naked eye and not visible during microscopic examination. In addition, the more modern MRI method helps to see such minute changes in the eye that cannot be studied using older methods.

Due to the high diagnostic value of MRI of the orbits, it can be prescribed for diagnosing a variety of eye pathologies:

• inflammatory processes localized in various layers of the organ of vision,
• damage to the retina, such as retinal detachment,
• tumor processes in the organ area with determination of their exact location and size (even tumors of small sizes from 1 mm are determined),
• hemorrhages in the eye with determination of their cause, thrombosis of the blood vessels of the eye,
• injuries with determination of the severity and volume of damaged tissues, with the identification of foreign body residues that caused eye injury,
• changes in the corneal layer,
• dysfunction of the optic nerves (for example, if glaucoma is suspected), decreased visual acuity, the appearance of incomprehensible pain in the eye with a determination of its cause,
• the condition of the organ of vision in diabetes mellitus, hypertension and other pathologies in which the blood supply to the eye is disrupted.

Using MRI, you can determine the location of foreign bodies in the internal structures of the eye, identify inflammatory foci and assess their size, find hidden tumors and, under MRI control, take material for a biopsy.

If there has been an eye injury, MRI allows you to evaluate its consequences and complications, the size and nature of damage to internal structures as a result of the injury, and treatment options in each specific case.

When a person’s vision deteriorates or the motor activity of the eyes is impaired (squint appears, the patient cannot focus vision on a specific object), it is simply impossible to determine the cause without examining the internal structures. MRI makes it possible to see and evaluate the degree of damage (atrophy) to the muscles or nerves responsible for eye movement, and to outline measures to correct the defect.

Quite often, the cause of visual impairment and pain is hidden from us, and it can only be detected by virtually penetrating inside the eye, observing its work, and assessing the changes occurring there. This is precisely the opportunity that magnetic resonance imaging provides. And although the procedure is called MRI of the orbits, in fact it also allows you to visualize disorders of the visual muscles, nerves and lacrimal glands, pathologies of the eyeball, changes in fatty tissue, due to which its demand is increasingly growing.

, , ,

Preparation

MRI of the orbits and optic nerves is considered a simple and generally safe procedure that does not require special measures to prepare for diagnosis. It is usually prescribed by an ophthalmologist during a patient’s appointment and examination if making an accurate diagnosis causes him difficulty.

A person can undergo examination on the same day or later, when such an opportunity arises. The fact is that not all medical institutions are equipped with the necessary equipment. In addition, the MRI procedure will not be free for everyone.

The main condition for obtaining a high-quality image is the patient’s immobility during the examination, which the person is warned about in advance. If the patient is very nervous, has symptoms of claustrophobia or severe pain that does not allow him to remain still, taking sedatives that reduce nervous excitability is indicated.

Patients with mental disorders or serious eye injuries in which they experience unbearable pain require additional limb fixation. If the above measures do not help, the doctor may resort to anesthesia administered intravenously.

Since the examination of organs is carried out using a magnetic field, any metal objects that could distort it must be removed. We are talking about jewelry and clothing with metal elements (locks, buckles, buttons, buttons, decorative overlays, etc.). If there is metal in the body in the form of crowns, organ implants, electronic devices that support body functions, you need to tell the doctor about it during your appointment. It may be necessary to clarify the material of dentures if the patient is not sure of his information.

During MRI, contrast agents can be used, which facilitate the diagnosis of tumor and inflammatory processes and help assess the condition of blood vessels. This issue is also discussed in advance, because on the eve of the procedure (5 hours before it) the patient will have to refuse food so that no components from the food can affect the result of the study. The best option is to administer contrast on an empty stomach.

To exclude contrast agent intolerance and anaphylactic reactions, before administering the drug, a test is carried out by applying the drug to exposed skin in the wrist area. The doctor must check the patient’s weight, because the volume of contrast administered depends on this.

The drug is administered intravenously as injections or infusions (drips) into the elbow area. The patient may feel dizziness, fever, hot flashes, nausea, but this is not scary, since it is considered a normal reaction of the body to contrasts. The administration of drugs for MRI of the orbits with contrast is carried out under the supervision of a physician. The patient is monitored by medical staff for the next 30 minutes.

Half an hour after the administration of drugs, the active substance of which accumulates in different tissues in different concentrations, you can begin MRI diagnostics. During this time, the medicine will spread through the bloodstream and reach the area under study.

Technique for performing MRI of the eye orbits

MRI of the orbits, like any other diagnostic procedure, is not performed for the sake of interest. Therefore, it must be taken seriously. After examining the patient by a specialist, he gives a referral for a diagnostic study. With this direction and the results of previous studies of the visual organs, the patient is sent to the diagnostic room.

The radiography we are used to is somewhat different from magnetic resonance imaging, although both studies are identical and pursue the same goals. An uninitiated person may be a little shocked by the device in the form of a long, voluminous pipe located horizontally. It is in this tube (capsule) that a magnetic field is created, which makes it possible to obtain on the screen an image of the organ under study in all details.

To relieve stress and fear of the device and the procedure, the patient is explained how an MRI of the eye is done, what the procedure can show in each specific case, what consequences this study has for the body.

The operating principle of magnetic resonance devices of open or closed type is based on recording the movement of hydrogen atoms saturating body tissues under the influence of a magnetic field. The illumination of different areas of the image depends on the number of gas molecules accumulated there.

The MRI procedure is quite complex to perform and requires the patient to remain motionless. This is easiest to do in a horizontal position, when the person is as relaxed as possible. For these purposes, the tomograph has a retractable table on which the patient is placed, fixing his head in a special device. If necessary, other parts of the body can be secured with belts.

Since only the head area is examined, the table is shifted so that only this area is inside the apparatus. The torso is outside the tomograph.

Before starting the procedure, patients are asked to use earplugs, since the device has a not very pleasant monotonous sound, which can cause anxiety and cause unwanted movements.

The procedure itself is considered quite lengthy compared to radiography. It takes from 20 to 40 minutes, during which the person must lie still. If contrast agents are used during the study, the procedure may take another twenty minutes.

During the examination, the doctor is usually located outside the diagnostic room, but the patient can contact him at any time via speakerphone if an attack of claustrophobia or any other problem occurs, for example, chest pain, shortness of breath, a feeling of lack of air, which happens during the procedure with contrast. In the same way, the doctor can give the necessary instructions to the patient.

To reduce nervous tension and calm the patient, it is allowed to invite relatives to the procedure. This is especially important if the diagnosis is performed on a child. After all, the MRI machine is universal, so it is large and can be frightening for a small patient.

Contraindications for carrying out

Magnetic resonance imaging (MRI) is considered one of the safest procedures because, unlike computed tomography (CT) and radiography, it does not require the use of harmful x-rays. The magnetic field in the tomograph does not harm the health of a person of any age or condition, so health problems are more likely indications for the study than contraindications to it.

The only absolute contraindication to MRI is the presence of ferromagnetic alloys and electronic devices (pacemakers, electronic middle ear implants, etc.) in the human body. The magnetic field can negatively affect the operation of the pacemaker, simulating the heart rhythm and cause malfunctions of electronic microscopic equipment implanted in the body.

As for metal implants made of ferromagnetic alloys and metal fragments stuck in the body (for example, after injuries), the danger of the influence of a strong magnetic field is that under its influence ferromagnetic materials can noticeably heat up, causing tissue burns, and move from place. Thus, the magnetic field can negatively affect ferromagnetic and large metal implants, Elizarov devices, ferromagnetic middle ear simulators, inner ear prostheses containing ferromagnetic elements, vascular clips made of ferromagnetic materials installed in the brain area.

Some metal implants (insulin pumps, nerve stimulators, valve prostheses, hemostatic clips, dentures, braces, endoprostheses, etc.) can be made from materials that have weak ferromagnetic properties. Such implants fall into the category of relative contraindications, but they must be reported to the doctor, indicating the materials from which the device is made. After all, even these devices may contain ferromagnetic elements, and the doctor must assess how dangerous the effect of a magnetic field on them will be.

As for dentures, most of them are made of titanium, a metal with weak ferromagnetic properties, i.e. the magnetic field during MRI is unlikely to cause a reaction from the metal. But titanium compounds (for example, titanium dioxide, used in tattoo inks) can react differently to a strong magnetic field, causing burns on the body.

In addition to non-ferromagnetic implants, relative contraindications include:

• early stages of pregnancy (there is not enough information about the effect of the magnetic field on the development of the fetus during this period, but this method is considered more preferable and safer than CT or X-ray),
• heart failure in the stage of decompensation, serious condition of the patient, the need for constant monitoring of the body, bronchial asthma, severe dehydration
• fear of closed spaces or claustrophobia (due to the inability to conduct research in a person who, out of fear, cannot maintain a motionless position for half an hour or more),
• inadequate condition of the patient (alcohol or drug intoxication, mental disorders will not allow clear pictures to be taken due to constant motor reactions),
• tattoos on the body made using inks containing metal particles (there is a risk of tissue burns if these are ferromagnetic particles).
• inner ear prostheses that do not contain ferromagnets.

In these cases, the decision about the possibility of performing MRI of the orbits is made by the doctor, taking into account the possible negative impact. In some cases, it is more appropriate to postpone the procedure for the time necessary to normalize the patient’s condition.

If we are talking about MRI with contrast, the list of contraindications becomes longer; after all, it requires the introduction of chemicals into the body, the reaction to which can be dangerous.

MRI with contrast is not performed:

• pregnant women, regardless of the stage of pregnancy, due to the ease of penetration of drugs through the placental barrier (the effect of contrasts on the fetus has not yet been studied),
• in case of chronic renal failure (contrast is removed from the body within 1.5-2 days, but in case of impaired renal function it may be delayed for a longer period, because the recommended consumption of large amounts of fluid is considered unacceptable),
• with hypersensitivity to contrast agents due to the risk of developing severe allergic and anaphylactic reactions.
• patients with hemolytic anemia.

Before undergoing an MRI procedure, for his own good, the patient is obliged to tell about any metal objects in his body, including fragments from wounds, tattoos and cosmetics used (or better yet, not to use cosmetics), remove all types of jewelry, watches, and clothes with metal elements.

Normal indicators

MRI of the orbits and optic nerves is a diagnostic test that is prescribed for a specific purpose. The purpose of the study is to identify pathological processes in the tissues of the eye or evaluate the results of treatment if MRI is prescribed again.

MRI allows you to study in detail the shape and quality of development of the orbits, the location and shape of the eyeballs, the condition of the fundus, the structure and course of the optic nerve, and identify dystrophic changes in it and other abnormalities.

Using MRI of the orbits, you can evaluate the condition of the optic veins and muscles responsible for the movements of the eyeball (their location, the presence of seals and tumors), and the fatty tissue of the orbits.

MRI is used to detect damage to the retina, which is the inner lining of the eye. The fact is that retinal damage does not have to be associated with eye or head trauma. Some pathologies of the inner lining of the organ of vision are associated with various systemic diseases (diabetes mellitus, hypertension, pathologies of the kidneys and adrenal glands). Magnetic resonance imaging helps to identify pathologies such as retinal detachment, diabetic or hypertensive retinopathy, damage to the vessels that supply nutrition to the retina, dystrophy or degeneration of this part of the eyeball, tumor and inflammatory processes, and retinal rupture.

MRI of the orbits with contrast allows you to assess the condition of the vessels of the eye, their blood supply, the presence of blood clots and ruptures. With the help of contrast agents it is easier to recognize internal inflammation. But most often the technique is still used to identify tumors when cancer is suspected. Using MRI, you can not only detect a tumor in a certain area of ​​the eye, but also evaluate its shape and size, the presence of metastases, the impact on nearby structures and the possibility of removal.

Any deviations in shape, size, and tissue density identified by MRI of the orbits provide the doctor with valuable information necessary to make a final diagnosis. In addition, during diagnostic procedures, some damage to the brain can be detected, which is also visible on the tomogram.

An example of an orbital MRI protocol might look like this:

Study type: primary (if the study is repeated, also indicate the date of the previous one, with which the results will be compared).

The eye sockets have regular development, a pyramidal shape with clear and even contours of the walls. No foci of destruction or compaction are observed.

The eyeballs are spherical in shape and symmetrically located relative to the eye sockets. The vitreous tissue is homogeneous, no changes in the MR signal are observed (this indicates the normal state of the organ, for example, in inflammatory processes the MR signal will be hyperintense, in tumors it will be isointense or hyperintense).

No thickening of the membranes of the eye is observed. They have smooth and clear contours.

The optic nerves are characterized by a regular course and clear contours without dystrophic changes or local thickening.

Orbital structures: The muscles of the eyeball have the correct location, there are no thickenings on them. Fatty tissue, ocular vessels and lacrimal glands are without features. The grooves of the convexital surface of the brain are unchanged.

Visible brain structures: There is no displacement of the midline structures. The cisterns of the medullary base are not deformed. The lateral ventricles of the brain are of normal size and symmetrical in location. There are no areas of pathological density in the area of ​​brain structures.

Other finds: No.

The MRI protocol (deciphering) described above suggests that no pathological changes in the human visual organs have been identified.

After receiving the image and research protocol (and you will have to wait about 30 minutes for them), the patient is sent to an appointment with an ophthalmologist, and sometimes a neurologist, to make a final diagnosis and prescribe the necessary treatment.

, , [

MRI of the orbits is a non-invasive procedure, i.e. It is possible to examine the internal structures of the eye without opening the tissues. This is another advantage of the modern diagnostic method.

Under MRI guidance, additional diagnostic studies can be performed, for example, a biopsy if a malignant tumor process inside the eye is suspected. And a tumor can be easily detected at an early stage of its development and is small in size. This helps to make an ideal MRI with contrast.

The three-dimensional image allows you to assess the condition of the organ in all details, the only thing is that it is not possible to obtain a clear image of the walls of the orbits, but all other structures are determined with great accuracy and without the health hazard that exists when performing a CT scan. The safety of the magnetic resonance method allows its use in the diagnosis of ophthalmological and other diseases in children. True, the procedure is prescribed for children over 7 years old, who are already able to remain motionless for a long time and comply with the doctor’s requirements.

The disadvantages of the method are the high cost, the relatively long duration of the procedure with the need to maintain a static position throughout the entire examination period (which is not as simple as it seems), the likelihood of heart rhythm disturbances and a large number of contraindications associated with metal and electronic implants.

However, safety for the body is more important than any money, and time is not an issue when it comes to accurate diagnosis and human health. Those categories of people who cannot undergo an MRI examination can resort to other diagnostic methods (X-ray, slit lamp, eye biomicroscopy, etc.), so they will not be left without the help of doctors.

Complications during MRI of the orbits can only occur if contraindications to the procedure are ignored. And then in most cases they are limited to minor tissue burns or distortion of research results if the patient does not report a tattoo or implant. Typically, those people who have devices installed that monitor the functioning of vital organs and systems do not forget about them and always inform them before prescribing diagnostic tests. But if the information was hidden intentionally, this is the responsibility of the patient himself, who was informed about the requirements for high-quality diagnostics even before the start of the procedure.

Targeted MRI of the orbits is a highly informative diagnostic method that is used for anatomical study of the structure of the orbits, as well as to identify various diseases of the visual organs. It provides a comprehensive picture of the shape, depth and distribution of formations or inflammatory processes at the level of scanning the orbits and visual pathways.

Magnetic resonance imaging allows you to accurately localize the tumor process in the orbits, optic nerves, muscles, eyes, chiasm and nearby structures. The technique allows specialists to evaluate in detail the condition of soft tissues, arteries and veins, as well as local blood supply.

Today, MRI makes it possible to detect any morphological changes in the visual analyzer, which is important for early verification of potentially dangerous pathological changes.

Types and costs

Study with contrast - additional 4950 rubles

The prices indicated on the website are not a public offer (according to Article 435-437 of the Civil Code of the Russian Federation). You can find out the exact cost of studies and additional services from the administrators of our MRI centers by calling the numbers listed on the website or using the feedback form.

Preliminary preparation before the procedure: not required.

Scan time: about 25-30 minutes; when examining with a contrast agent, the scanning time increases to 40-45 minutes.

Time to prepare a medical report: from 20 minutes or more (depending on the category of complexity of a particular case) after the scanning procedure.

Indications for the study:

Diagnosis of a volumetric process of benign and malignant nature,

Suspicion of the presence of foreign bodies in the eye and retrobulbar space,

Eye injuries,

Decreased visual function,

Optical aberrations,

Suspicions of retinal vascular thrombosis and retinal detachment,

Hemorrhages,

Sharp pain in the eye,

Exophthalmos and others,

Inflammation of the optic nerve, retrobulbar tissue, lacrimal glands or extraocular muscles.

Contraindications to medical services:

It is known that the MRI technique does not involve the use of ionizing radiation, and this is its important advantage. However, it is necessary to strictly observe certain precautions when performing MRI, due to the fact that the method is strictly contraindicated for a certain group of people, namely:

1. patients with pacemakers and implanted cardiac defibrillators (non-removable);
2. patients with foreign metal fragments in the eye area;
3. patients with cochlear implants (non-removable);
4. patients with implanted neurostimulators (non-removable);
5. patients with aneurysmal ferromagnetic clips (non-removable);
6. patients with shrapnel and bullet wounds and the presence of metal fragments in the body;
7. patients with portable insulin pumps (non-removable).

The above conditions form a group of absolute contraindications to MRI and require immediate refusal to conduct the study.

We take patient safety very seriously. When registering for a study, call center operators must check the presence of implants or other metal elements. In addition, before the procedure, our employees will provide you with an informed consent questionnaire to identify any contraindications.

According to WHO, one adult in the world loses his sight every five seconds, and every minute a child. Moreover, in 75% of cases, the diseases that cause blindness are completely curable if detected in a timely manner. One of the most informative methods for diagnosing the organs of vision is MRI of the eye. This procedure is non-invasive and is absolutely painless for the patient. It allows you to detect even in the early stages tumors and inflammatory processes in the orbit, diseases of the optic nerve, foreign objects, disorders of the structure of the vitreous body and many other pathologies.

Where can I get an MRI of the eye?

This type of examination is carried out by quite a few clinics in Moscow and other large cities of Russia. However, when looking for a place where you can do an MRI of the eye, you should still pay attention to the quality of the equipment and methods for performing this procedure. Many doctors recommend using contrast when conducting such an examination. This allows you to significantly increase the accuracy of determining the location and size of pathologies, which greatly facilitates subsequent treatment. The contrast agent is made from a paramagnetic material and is administered intravenously.

MRI is quite often used in ophthalmology to diagnose diseases affecting the organs of vision. Magnetic resonance imaging, as well as laser Doppler flowmetry, non-contact tonometry, perimetry, is a modern and very informative examination method. MRI is often performed when a tumor process is suspected (malignant neoplasm, metastasis).

The MRI method is based on the reaction of nuclei in hydrogen atoms in response to external radiation. In this case, all reactions at the atomic level are recorded and translated into an image. As a result, the doctor receives a thorough picture of the occurring pathologies.

Indications for the study

MRI of the eye and its orbit is performed in the presence of the following possible conditions:

• Retinal vascular thrombosis;
• Presence of foreign bodies (in the eyeball or retrobulbar space);
• Significant sudden decrease in visual function;
• Post-traumatic transformations of eye structures;
• Degenerative processes, including optic nerve atrophy;
• Hemorrhage into the structures of the eyeball;
• Suspicion of retinal detachment;
• Inflammation inside the eye (optic nerve, other structures) or in the orbital area (retrobulbar tissue, extraocular muscles, lacrimal gland);
• Discomfort, the cause of which could not be determined (exophthalmos, sharp painful sensation in the eyeball).

Diagnosis of diseases

With magnetic resonance imaging, the doctor receives information about the depth, shape, area of ​​the tumor or inflammation. Using MRI of the eye, you can accurately determine the location of the tumor in relation to other structures of the eye. The structure of the optic nerve, extraocular muscles, and intracranial formations is also clearly visible. This method of examining patients helps to evaluate all the details of the structures of the eyeball and clarify the pathology of the blood supplying vessels and soft tissues of the eye.

Contraindications of the method

If you have certain conditions, MRI of the eye cannot be performed, and sometimes it can be dangerous:

• The presence in the patient’s body of any metal structures, which include an insulin pump, pacemaker, vascular clips. This is due to the fact that during MRI a magnetic field is created, which leads to disruption of the functioning of these vital mechanisms. Also, if you have some types of tattoos, you cannot perform an MRI because some of the inks used to apply designs to the skin contain metals.
• You should not perform an MRI of the eye while pregnant or during lactation. This is due to the use of contrast during the study. Substances administered intravenously may have a negative effect on the child or fetus, since their safety for this category of patients has not been studied.
• In case of chronic renal failure in the stage of decompensation, MRI with contrast is also problematic. This is due to the fact that all contrast agents have a nephrotoxic effect and are excreted mainly in the urine. If kidney function is impaired, the contrast is retained in the body and aggravates the negative effect.
• There are frequent cases of allergic reactions to the administration of a contrast agent. The severity of allergies can vary and sometimes reaches anaphylactic shock. If a patient has a history of negative reactions to a contrast agent, then an MRI with contrast should not be performed.

It should be noted that dental implants, the presence of braces or artificial joints are not a contraindication to MRI of the eye.

How is the MRI procedure performed?

MRI of the orbits is a rather complex procedure for both the doctor and the patient. However, this study does not require special preparation. If all precautions are followed, MRI becomes a practically safe procedure that does not cause consequences. Therefore, before starting the examination, it is necessary to exclude all possible contraindications.

The duration of an MRI of the eye can be up to an hour if performed with the introduction of contrast, and half an hour with the standard mode. During the examination, the patient lies on a special table that has a head restraint. The tomograph tube contains only the area being examined, that is, the head. In order for the images to be most informative, it is necessary to exclude any movements during the MRI. When performing an MRI with contrast, a contrast agent is first injected into the patient's vein. Due to the fact that this procedure is quite noisy, the patient is offered earplugs to ensure maximum comfort. Some people, especially those suffering from claustrophobia, are allowed the presence of close relatives during an MRI so that they can provide all possible support. The doctor is usually behind glass and gives instructions to the patient over a speakerphone through a microphone. After receiving the images on the computer, the doctor will need about another half an hour to evaluate the results and, if necessary, print the images.

Advantages and disadvantages of the method

MRI diagnostics has a number of significant advantages over other methods:

• Minimum amount of radiation exposure to the body;
• Very high information content;
• There are no invasive procedures that require breaking the integrity of the skin.

Due to the peculiarities of MRI, in some cases it is not possible to clearly determine the walls of the orbit, which can be considered the main disadvantage of the technique.

Alternative Methods

MRI of the eye is used relatively rarely because it is quite expensive. More often, the patient is prescribed a set of procedures (determining the level of intraocular pressure, examination using a slit lamp, electrooculography). If it is not possible to determine the nature of the pathology, then an additional MRI of the eye and orbit is prescribed.