CT Head and Orbit Indications

Orbital Infections

The American College of Radiology recommends CT orbits with IV contrast as the most useful imaging for suspected orbital infections, helping differentiate preseptal from postseptal cellulitis and detecting orbital abscesses 1, 4
The American College of Radiology suggests CT head with IV contrast should be added when intracranial complications of orbital cellulitis are suspected 1, 5
The American College of Radiology states that precontrast imaging is typically not necessary in these cases as it doesn't add significant diagnostic information 1
The American College of Radiology recommends MRI of orbits and head with contrast to complement CT when more detailed assessment of intraorbital spread of infection is needed or when intracranial complications are suspected 1, 3

The American College of Radiology recommends CT head and orbits with IV contrast for differentiating various causes of leukocoria and evaluating the extension of retinoblastoma along optic nerves and intracranially 3, 5
The American College of Radiology suggests MRI of head and orbits with and without IV contrast as the most useful imaging modality for evaluating malignant intraocular masses, particularly retinoblastoma 3
The American College of Radiology states that MRI is superior for showing retrolaminar optic nerve infiltrations, orbital invasion, and possible intracranial spread of tumors 3
The American College of Radiology recommends CT for detecting calcifications, which helps differentiate retinoblastoma from other conditions like PHPV and Coats disease 3

The American College of Radiology recommends non-contrast thin-section orbital CT with multiplanar reconstructions for suspected metal foreign bodies in the eye 2
The American College of Radiology suggests CT is superior to MRI for foreign body assessment, calcification detection, and osseous evaluation 2
The American College of Radiology states that MRI is contraindicated when metallic foreign bodies are suspected due to potential movement of the object caused by the magnetic field 2
The American College of Radiology reports that CT has 94.9% sensitivity for detection of intraorbital foreign bodies, especially metallic ones 2

The American College of Radiology recommends MRI of the head and orbits with and without IV contrast as the most useful imaging modality for evaluating acute nontraumatic vision loss 7
The American College of Radiology suggests CT head without IV contrast may complement MRI when infarct or hemorrhage in the neurovisual pathway is suspected 7
The American College of Radiology recommends MRI of the brain with contrast to evaluate the pituitary gland and optic chiasm for patients with junctional scotoma or bitemporal visual defects 2
The American College of Radiology suggests MRI of the brain with contrast as the preferred imaging modality for homonymous hemianopia or quadrantanopia defects 2

The American College of Radiology recommends CT as complementary to MRI in evaluating patients with ocular, orbital, and skull base neoplasms 2
The American College of Radiology states that CT provides additional information about adjacent bone involvement, including bone erosion, sclerosis, or periosteal reaction 2
The American College of Radiology suggests MRI is preferred for evaluating soft tissue abnormalities and intracranial extension 2