Different types of trochlear apparatus calcification: Evaluation with multidetector computed tomography (MDCT)
Abstract
Aim: Trochlear apparatus calcification (TAC) can be an incidental finding in multidetector computed tomography (MDCT) scans. TAC may be misdiagnosed as a foreign body especially in trauma patients. In this study we aim to determine the incidence and types of TAC with cranial and paranasal MDCT scans.
Materials and Methods: Consecutive 452 MDCT scans were evaluated retrospectively. Repeated exams and patients with orbital wall fracture history were excluded. CT scans were obtained by a 64-slice scanner with 0.5 mm slice thickness. Reformatted and three-dimension volume rendered images in bone window were used to assess the calcification presence and type.
Results: Four hundred forty-one MDCT exams included to study. TACs detected in 31 (7.5%) subjects. TAC was unilateral in 24 (77.4%) and bilateral in seven (22.6%) subjects. There was no significant correlation with aging (p=0.681) and between genders (p=0.808). “Dot-like” TAC was the most common type (n=12, 31.6%). The other types were “inverted-U” (n=11, 28.9%), “linear” (n=8, 21%), “comma” (n=6, 15.6%), respectively. Eight (21%) of TACs were attaching the orbital wall, mostly in “comma” type.
Conclusion: The TAC incidence in our study was compatible with literature. Four different types of TAC, including, “dot-like”, “inverted U”, “linear” and “comma” types detected. TACs were usually discrete from the orbital wall however they were occasionally attached. “Linear” type TAC and attachment to orbital wall described for the first time in this study. Knowledge of the TAC appearance may be helpful to differentiate TACs from foreign bodies.
References
- Murray JL, Hayman LA, Tang RA, Schiffman JS. Incidental asymptomatic orbital calcifications. J Neuroophthalmol 1995;15(4):203-8.
- Salha R, Shah J, Sidebottom AJ. Trochlear calcification with coexisting orbital foreign bodies: Case report and literature review. Oral Surgery 2015; 8(1):48-50.
- Froula PD, Bartley GB, Garrity JA, Forbes G. The differential diagnosis of orbital calcification as detected on computed tomographic scans. Mayo Clin Proc 1993;68(3):256-61.
- Ko SJ, Kim YJ. Incidence of calcification of the trochlear apparatus in the orbit. Korean J Ophthalmol 2010; 24(1):1-3.
- Xiao TL, Kalariya NM, Yan ZH, Chen W, Liu XQ, Zhao ZQ et al. Trochlear calcification and intraorbital foreign body in ocular trauma patients. Chin J Traumatol 2009;12(4):210-3.
- Mafee MF, Folk ER, Langer BG, Miller MT, Lagouros P, Mittleman D. Computed tomography in the evaluation of Brown syndrome of the superior oblique tendon sheath. Radiology 1985;154(3):691-5.
- Yanoff M, Duker SJ. Ophthalmology 2nd ed. St Louis: Mosby; 2003: 171-8.
- Hart BL, Spar JA, Orrison WW Jr. Calcification of the trochlear apparatus of the orbit: CT appearance and association with diabetes and age. AJR Am J Roentgenol 1992;159(6):1291-4.
- Buch K, Nadgir RN, Tannenbaum AD, Ozonoff A, Fujita A, Sakai O. Clinical significance of trochlear calcifications in the orbit. AJNR Am J Neuroradiol 2014;35(3):573-7.
- Çolak A, Energin F, Kaya M, Baykal O, Şen B, Tüfekçi A. Increased prevalence of trochlear apparatus calcifications in diabetes mellitus: A prospective study by orbital CT appearance. Turk J Med Sci 1997;27(1):67-70.
- Lin KY, Ngai P, Echegoyen JC, Tao JP. Imaging in orbital trauma. Saudi J Ophthalmol 2012;26(4):427-32.
- Bailey W, Robinson L. Screening for intra-orbital metallic foreign bodies prior to MRI: Review of the evidence. Radiography 2007;13(1):72-80.
- Sobel RK, Goldstein SM. Trochlear calcification: A common entity. Orbit 2012;31(2):94-6.
Troklear aparat kalsifikasyonunun farklı tipleri: Çok kesitli bilgisayarlı tomografi (ÇKBT) ile değerlendirme
Abstract
Troklear aparat kalsifikasyonu (TAK), çok kesitli bilgisayarlı tomografi (ÇKBT) incelemelerinde rastlantısal bir bulgu olabilir. TAK özellikle travma hastalarında yanlışlıkla yabancı cisim olarak değerlendirilebilir. Bu çalışmada amacımız kraniyal ve paranasal sinüslere yönelik ÇKBT incelemelerinde TAK sıklığını ve tiplerini belirlemektir.
Gereç ve Yöntem: Ardışık 452 ÇKBT incelemesi retrospektif olarak değerlendirildi. Tekrar edilmiş incelemeler ve travma öyküsü bulunan hastaların görüntüleri değerlendirme dışı bırakıldı. BT incelemeleri 64-dedektörlü cihazla 0.5 mm kesit kalınlığında elde olundu. Reformat ve üç boyutlu hacim kazandırılmış görüntüler, kalsifikasyon varlığı ve tipinin belirlenmesi için kullanıldı.
Bulgular: Çalışmaya 441 inceleme dahil edildi. 31 (%7.5) olguda TAK saptandı. TAK 24 (%77.4) olguda tek taraflı, 7 (%22.6) olguda iki taraflıydı. Yaşlanma (p=0.681) ve cinsiyet (p=0.808) ile anlamlı korelasyon saptanmadı . “Nokta-benzeri” en sık görülen TAK tipiydi (n=12, % 31.6). Diğer tipler sırasıyla “ters-U” (n=11, %28.9), “çizgisel” (n=8, %21), “virgül” (n=6, %15.6) şekildeydi. En fazla “virgül” şekilli olmak üzere, TAK’ların 8’i (%21) orbita duvarına yapışık görülmekteydi.
Sonuç: Çalışmamızda bulunan TAK sıklığı literatür ile uyumluydu. “Nokta-benzeri”, “ters-U”, “çizgisel” ve “virgül” şeklinde olmak üzere TAK’ın dört farklı tipi saptandı. TAK genellikle orbita duvarından ayrık izlenmesine rağmen ara sıra duvara yapışık olduğu görüldü. “Çizgisel” tip TAK ve orbita duvarına yapışık olması ilk defa bu çalışmada tanımlanmıştır. TAK farklı görünüm şekillerinin bilinmesi, TAK’larının yabancı cisimden ayrılmasında yararlı olabilir.
References
- Murray JL, Hayman LA, Tang RA, Schiffman JS. Incidental asymptomatic orbital calcifications. J Neuroophthalmol 1995;15(4):203-8.
- Salha R, Shah J, Sidebottom AJ. Trochlear calcification with coexisting orbital foreign bodies: Case report and literature review. Oral Surgery 2015; 8(1):48-50.
- Froula PD, Bartley GB, Garrity JA, Forbes G. The differential diagnosis of orbital calcification as detected on computed tomographic scans. Mayo Clin Proc 1993;68(3):256-61.
- Ko SJ, Kim YJ. Incidence of calcification of the trochlear apparatus in the orbit. Korean J Ophthalmol 2010; 24(1):1-3.
- Xiao TL, Kalariya NM, Yan ZH, Chen W, Liu XQ, Zhao ZQ et al. Trochlear calcification and intraorbital foreign body in ocular trauma patients. Chin J Traumatol 2009;12(4):210-3.
- Mafee MF, Folk ER, Langer BG, Miller MT, Lagouros P, Mittleman D. Computed tomography in the evaluation of Brown syndrome of the superior oblique tendon sheath. Radiology 1985;154(3):691-5.
- Yanoff M, Duker SJ. Ophthalmology 2nd ed. St Louis: Mosby; 2003: 171-8.
- Hart BL, Spar JA, Orrison WW Jr. Calcification of the trochlear apparatus of the orbit: CT appearance and association with diabetes and age. AJR Am J Roentgenol 1992;159(6):1291-4.
- Buch K, Nadgir RN, Tannenbaum AD, Ozonoff A, Fujita A, Sakai O. Clinical significance of trochlear calcifications in the orbit. AJNR Am J Neuroradiol 2014;35(3):573-7.
- Çolak A, Energin F, Kaya M, Baykal O, Şen B, Tüfekçi A. Increased prevalence of trochlear apparatus calcifications in diabetes mellitus: A prospective study by orbital CT appearance. Turk J Med Sci 1997;27(1):67-70.
- Lin KY, Ngai P, Echegoyen JC, Tao JP. Imaging in orbital trauma. Saudi J Ophthalmol 2012;26(4):427-32.
- Bailey W, Robinson L. Screening for intra-orbital metallic foreign bodies prior to MRI: Review of the evidence. Radiography 2007;13(1):72-80.
- Sobel RK, Goldstein SM. Trochlear calcification: A common entity. Orbit 2012;31(2):94-6.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | December 1, 2017 |
| Submission Date | February 16, 2016 |
| Published in Issue | Year 2017Volume: 56 Issue: 4 |
