The contribution of echography in the diagnosis of proptosis

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Abstract
Echography was used to examine the retro-bulbar space of 150 patients with proptosis. An NE Diasonograph was used with an 8 MHz probe using a water bath in the supine position. Lesions were classified ultrasonically as tumor, inflammatory edema (including pseudo-tumor or other granulomas), traumatic, dysthyroid ophthalmopathy, or normal. Patients (31) were placed in the tumor group, but 3 of these were subsequently found to have granulomas. One patient with a normal ultrasonic appearance had a meningioma en plaque at operation. There were no false positive results in the inflammatory group, but 1 patient with a normal ultrasonic appearance was eventually diagnosed as having an orbital inflammatory process. The ultrasonic findings in inflammatory disease were non-specific, and 3 were associated with or possibly caused by venous thrombosis or arteritis of the orbit. The changes must be distinguished from thyroid ophthalmopathy, but this disorder is generally bilateral which is unusual in inflammatory disease. Traumatic edema and hemorrhage were distinguished by the obvious antecedent history. Because of the variability of the amount and position of the retro-bulbar fat in the posterior part of the orbit, it was necessary to make a comparative scan of the normal orbit in all patients with suspected retro-bulbar pathology.

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