ABSTRACT
OBJECTIVES: To describe the diagnostic challenge associated with magnetic resonance imaging (MRI) artifact and to describe methods of minimizing this artifact. METHODS: Gadolinium enhancement was demonstrated to be artifact by using an inversion recovery pulse sequence technique. RESULTS: A patient with complaints of painless loss of vision also had radiologic abnormalities that led to subsequent referral to a tertiary care facility. Increased signals on the fat-suppressed contrast enhanced MRI was demonstrated to be artifact by using an inversion recovery technique which produced a normal MRI of the orbit. CONCLUSIONS: Clinical confusion leading to unnecessary and costly evaluation may be avoided if one considers the possibility of artifact when reviewing magnetic resonance studies. When magnetic susceptibility is suspected, the use of an inversion recovery sequence can better delineate the true nature of the abnormality.
Subject(s)
Artifacts , Gadolinium , Magnetic Resonance Imaging , Orbital Diseases/diagnosis , Vision Disorders/diagnosis , Adult , Humans , Image Enhancement , Magnetic Resonance Imaging/methods , MaleABSTRACT
PURPOSE: To characterize the clinical presentation of Mycobacterium fortuitum dacryocystitis, an unusual microbial cause of this disease. METHODS: The authors present a detailed description of a case of M. fortuitum chronic dacryocystitis and a review of the literature. FINDINGS: Although M. fortuitum is a well-recognized cause of chronic keratitis and corneal ulcer, it has only been reported once previously as a cause of dacryocystitis. Multiple factors that alter the ocular environment of the host may predispose to infection with this organism. The diagnosis requires isolation of the organism in the appropriate clinical setting. The authors' case represents the first patient successfully treated with dacryocystectomy. CONCLUSION: M. fortuitum is a rare cause of chronic dacryocystitis that may respond favorably to surgical therapy alone.
