Magnetic resonance imaging and computed tomography for the detection and characterization of nonmetallic intraocular foreign bodies.

Abstract

To perform a comprehensive comparative analysis of nonmetallic intraocular foreign bodies (IOFBs) using computed tomography (CT) and magnetic resonance imaging (MRI). An ex vivo model of porcine eyes was used to study IOFBs consisting of 10 different materials: plastic, eyeglass lens, bottle glass, windshield glass, porcelain, gravel stone, concrete, wood, thorn, and pencil graphite. The study included 30 eyes with IOFBs and 6 control eyes. Each eye was scanned by CT and MRI. Images were analyzed by three-dimensional viewing software to determine distinguishing characteristics for each material. Analysis of MRI and CT scans yielded distinguishing characteristics for each of the 10 materials, and this information was integrated into a clinical algorithm that enables their distinction. More materials were identified by MRI than by CT, and smaller IOFB size was associated with lower detectability. Review of CT and head-coil MRI scans by masked specialists yielded a 95% agreement rate and allowed detection of most IOFBs. Magnetic resonance imaging was superior to CT in IOFB detection. Using these modalities, a set of distinguishing characteristics was established for the identification of the 10 studied materials. We recommend MRI to be part of the evaluation of patients with a suspected IOFB, after CT to rule out metallic IOFBs.