Removable Eye Makeup Must Be Washed Off Prior To A Scan. Why?

Turk J Ophthalmol. 2018 Jun; 48(3): 158–159.

Kajal-induced Artefact Simulating a Ciliary Body Tumor on Magnetic Resonance Imaging

Venkatraman Indiran

¹Sree Balaji Kinesthesia of Medicine Infirmary, Ophthalmology Dispensary, Chennai, India

L. Raguram Subha

¹Sree Balaji Kinesthesia of Medicine Hospital, Ophthalmology Dispensary, Chennai, Republic of india

Jagannathan Kokilavani

²VK Clinic, Ophthalmology Clinic, Chennai, Republic of india

Received 2017 Dec 13; Accepted 2018 Jan 17.

Keywords: Artifact, magnetic resonance imaging, susceptibility

Dear Editor,

It is well known that magnetic resonance imaging (MRI) is a boon to the field of neurological and orbital imaging but it is equally of import to be aware of the various artefacts and practical issues associated with them. Here nosotros written report such an instance where we encountered an eyeball lesion in the region of the ciliary body which disappeared on more detailed evaluation. Awareness of the possibility of such pseudolesions and the reasons for their occurrence is essential to avoid misinterpretation as true pathological lesions.

A 34-yr-one-time female person presenting with history of headache was found to take a small nodular T2 hypointense lesion with a thin hyperintense border in the medial aspect of the left eyeball in the retrolental region (Figure 1). There was blooming on the gradient images merely the lesion was not seen conspicuously on other images. The postgraduate resident raised the possibility of a ciliary body tumor.

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Axial T2-weighted images (A, B) show pocket-sized nodular T2 hypointense lesion with a thin hyperintense border in the medial aspect of the left eyeball in the retrolental region (arrows)

However, every bit the lesion appearance was not characteristic of whatever condition, I wished to see the patient in person to see if she had applied any cosmetic products. She had applied kajal (an center cosmetic) before the MRI scan and had non removed it. We thought the observed lesion could exist due to susceptibility artefact arising from the applied kajal. We rescanned the patient afterwards asking her to wash her face and making certain that there was no kajal effectually her eyes. Repeat MRI scan with routine T2 and thin heavily T2-weighted sections showed no lesion in the eyeball (Figure 2). A careful ophthalmological examination with dilated pupils also ruled out a solid ciliary torso mass.

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Axial 5 mm-thickness T2-weighted paradigm (A) and thin heavily T2-weighted ane mm section (B) showed no lesion in the eyeball (arrows)

Patients having MRI scans every bit outpatients may present for examination later applying cosmetics including heart makeup, face lotions, boom polish and pilus loss concealers. Eye and confront makeup products may crusade artefactual distortion of the orbital contents due to the iron oxide in the pigments used to produce night shades of makeup. Though these artefacts do not interfere with brain imaging, information technology precludes imaging of orbital contents if they are of clinical concern. This susceptibility artefact is usually propagated along the frequency-encoding axis of the images.ⁱ Susceptibility artefacts caused past eye makeup may mimic ocular illness such as ciliary body melanoma or cyst.^two The susceptibility artefacts are expectedly more prominent in clan with 3-Tesla MR systems than lower field strengths. Escher and Shellock³ in their study involving 38 dissimilar types of cosmetics on 3-Tesla MRI constitute that all 5 of the eyeliners, all 3 of the mascaras, 3 of the 10 eye shadows and the 1 hair concealer created modest to very large artefacts which were related to the presence of iron oxide or other metal-based ingredient.

Every bit it is prudent to preclude these artefacts, it would exist very wise to advise patients to thoroughly remove all cosmetics earlier they arrive for MRI exams. According to American College of Radiology guidelines, all individuals undergoing an MR process must remove all readily removable metallic personal belongings and devices, body piercings (if removable), cosmetics containing metal particles (such equally center make-upward) and clothing items with metallic fasteners, hooks and zippers.⁴ Though ferromagnetic detection systems have been used in screening MRI patients primarily to prevent accidents related to external ferromagnetic objects like pocket knives, a colonnade-type ferromagnetic detection system may be a useful offshoot to screen patients for biomedical implants and embedded foreign bodies.⁵

We would like to emphasize the importance of removing cosmetic products from the parts of the trunk to be scanned by the MRI to avoid wrong diagnosis and loss of diagnostic information.

Footnotes

Ethics

Peer-review: Internally peer-reviewed.

Contributed by

Authorship Contributions

Surgical and Medical Practices: Venkatraman Indiran, L. Raguram Subha, Jagannathan Kokilavani, Concept: Venkatraman Indiran, L. Raguram Subha, Jagannathan Kokilavani, Blueprint: Venkatraman Indiran, Fifty. Raguram Subha, Jagannathan Kokilavani, Data Collection or Processing: Venkatraman Indiran, L. Raguram Subha, Analysis or Interpretation: Venkatraman Indiran, L. Raguram Subha, Literature Search: Venkatraman Indiran, 50. Raguram Subha, Jagannathan Kokilavani, Writing: Venkatraman Indiran, Jagannathan Kokilavani.

Disharmonize of Involvement: No conflict of interest was declared by the authors.

Financial Disclosure: The authors declared that this study received no financial back up.

References

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