Radiology MRI

Coronal T2 showing well defined homogeneous intraorbital tumor that grows externally from optic nerve sheath. Note black dot corresponding with optic nerve (arrow heads). Second and third images are FS T1 with intravenous contrast showing homogeneous enhancing tumor. The optic nerve is displaced medial and cranial and can also be seen (arrow). Last image showing homogeneous and slightly high signal form the tumor on T2. Finding represents Optic Nerve Sheath Meningioma .

This case shows value of reconstructions in all three planes when evaluating skull fractures. Both coronal and sagittal reconstructions from the same scan clearly show horizontal fracture in the left parietal bone (arrows). However due to horizontal orientation the fracture is not well seen on the axial view. It can be recognized as a faint shadow (arrow head) that can easily be missed when only axial plane is evaluated. The clinical value of recognizing such fracture is indication of a high energetic trauma with more chance of brain contusion and hemorrhage. So the 'take home message' here is: Always look at all planes. Very similar case, but a different patient showing also value of 3D reconstructions: Skull Fracture Line .