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Show Joumal of Clillical Neuro-0l'hthalmology 7(4): 254. 1987 Letter to the Editor Neuroimaging To the Editor: I very much enjoyed the editorial regarding neuroimaging in the June 1987 issue of the JounIal of Clinical Neuro-ophthalmology. The summary table "Choice of imaging procedure in cranial and orbital abnormalities (a neuro-ophthalmologicneuroradiological consensus)" is really an excellent reference and agrees with my own experience with two slight exceptions. First, magnetic resonance in general may not be the procedure of choice for detection of aneurysm but it is superior to computerized tomography in the cavernous sinus both for aneurysm and thrombosis. Second, magnetic resonance is usually better than computenzed tomography for infarction but computeriZed tomography is preferable for detecting acute, hemorrhagic infarction. Also, one presumes that all information presented in your table supposes excellent computerized tomographic and magnetic 254 19 1987 Raven Press, Ltd., New York resonance modalities available. In general, high resolution computerized tomography is more widely available than state-of-the-art magnetic resonance and practitioners who are not intimately familiar with what their local machines can do ought always to consult with their radiologist before ordering a study. An excellent example is imaging of the sella which will ultimately be better with magnetic resonance but currently may be better with high resolution computerized tomography depending on what magnetic resonance unit and software is available to you. But, to go back to my original statement, this table is a marvelous current reference and, I suspect, will be of historical importance as we look back to 1987 from whatever neuroimaging is available 5, 10, or more years from now. Lyn A. Sedwick, M.D. 2501 North Orange Ave. Orlando, Florida |
