Reviews

Modern concept of orbital radiological imaging

Author

• • Sinisa Ristic sinisaristic@yandex.ru Email Sinisa Ristic. (compose email, opens in email app.)
  • University of East Sarajevo, Faculty of Medicine Foca, Foča, Republic of Srpska, Bosnia and Herzegovine

Abstract

Radiological imaging modalities, particularly computed tomography (CT) and magnetic resonance imaging (MRI), play a pivotal role in the diagnosis of orbital diseases. CT remains the gold standard for the evaluation of orbital trauma, including fractures, calcifications, and metallic foreign bodies, whereas MRI is superior for assessing soft tissues and the optic nerve. Characteristic radiological signs include the “I’M SLOW” pattern in Graves’ ophthalmopathy, the “tram-track” sign in optic nerve sheath meningioma, the “teardrop” sign in blowout fractures, and the “empty delta” sign in cavernous sinus thrombosis. An apparent diffusion coefficient (ADC) threshold value of 0.84 × 10⁻³ mm²/s has been shown to differentiate malignant from benign orbital lesions. The presence of a metallic intraocular foreign body represents an absolute contraindication to MRI examination. Artificial intelligence is increasingly contributing to orbital imaging through automated muscle segmentation, fracture detection, and prediction of tumor histology. Appropriate selection of imaging modality and recognition of these characteristic findings significantly improve diagnostic accuracy.

Keywords: orbit, MRI, diffusion-weighted MRI, Graves’ ophthal mopathy, fractures, artificial intelligence

How to Cite: Ristic, S. (2026) “Modern concept of orbital radiological imaging”, Biomedicinska istraživanja. 17(S1). doi: https://doi.org/10.59137/BII202601639R