Fat suppression applied to MR imaging of the pathologic orbit

Previous MR studies of the normal orbit have shown that fat suppression sequences applied at the proper T1-T2 weighting will decrease artifacts from chemical shift, and can be used to enhance contrast in selected anatomic regions. The purpose of this study was to evaluate the clinical application of fat suppression to studies of the pathologic orbit. The studies included conventional imaging sequences and comparative fat suppression sequences through a range of T1-T2 weighting (repetition time [TR] 400 msec, echo time [TE]20 msec, to TR 2,000 msec, TE 90 msec), using the chopper fat suppression technique developed by J. Szumowski and D. Plewes, which requires no postprocessing and no increased scan time to achieve relatively linear fat suppression. Fat suppression was advantageous in determining tumor margins (extension through sclera); increasing diagnostic specificity (fat vs. water content); detailing anatomic relationships along bony margins (particularly in the orbital apex); and for demonstrating true thickness of optic nerve separate from adjacent cerebrospinal fluid and fibrous sheath. Disadvantages included susceptibility to motion artifact and a perception of lower quality due to lower overall orbital signal