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Radiological Reasoning: Leukocoria in a Child

Nadja Kadom1 and Raymond W. Sze

1 Both authors: Department of Radiology, Children's National Medical Center, 111 Michigan Ave., Washington, DC 20010.


Figure 1
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  		Fig. 1 —10-month-old boy with leukocoria. Contrast-enhanced axial CT scan of orbit shows large calcified mass on right (short arrow) and small noncalcified mass on left (long arrow).

 

Figure 2
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  		Fig. 2 —Illustrative companion case, 17-year-old boy with optic nerve drusen. Unenhanced axial CT of orbit shows bilateral drusen with small calcifications (arrows) at level of optic disk.

 

Figure 3
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  		Fig. 3A —Illustrative companion case, 3-year-old girl with retinoblastoma. Unenhanced (A) and contrast-enhanced (B) axial CT scans of orbit shown with Hounsfield units reveal contrast enhancement that is hard to detect subjectively. Note increase in Hounsfield unit attenuation from M = 44.27 HU (A) to M = 70.81 HU (B).

 

Figure 4
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  		Fig. 3B —Illustrative companion case, 3-year-old girl with retinoblastoma. Unenhanced (A) and contrast-enhanced (B) axial CT scans of orbit shown with Hounsfield units reveal contrast enhancement that is hard to detect subjectively. Note increase in Hounsfield unit attenuation from M = 44.27 HU (A) to M = 70.81 HU (B).

 

Figure 5
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  		Fig. 4A —Illustrative companion case, 3-year-old boy with bilateral retinoblastoma shown on axial MRI. T2-weighted unenhanced image (A) of orbit shows dark mass along left lateral retina. Mass enhances on gadolinium-enhanced T1-weighted image (B). Note globe prosthesis on right side.

 

Figure 6
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  		Fig. 4B —Illustrative companion case, 3-year-old boy with bilateral retinoblastoma shown on axial MRI. T2-weighted unenhanced image (A) of orbit shows dark mass along left lateral retina. Mass enhances on gadolinium-enhanced T1-weighted image (B). Note globe prosthesis on right side.

 

Figure 7
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  		Fig. 5 —Illustrative companion case, 12-year-old girl with Coats' disease. Unenhanced axial CT scan of orbit shows unenhanced mass along right retina, normal-sized globe, and no calcifications.

 

Figure 8
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  		Fig. 6 —Illustrative companion case, 8-year-old girl with bilateral retinopathy of prematurity. Unenhanced axial CT scan of orbit shows bilateral microphthalmia, abnormal calcified tissue traversing right globe, and abnormally increased globe density and absent lens on left.

 

Figure 9
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  		Fig. 7A —Illustrative companion case, 10-year-old boy with persistent primary vitreous. Orbital axial T1-weighted MR image shows right microphthalmia, retrolental mass lesion, and bright signal of vitreous.

 

Figure 10
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  		Fig. 7B —Illustrative companion case, 10-year-old boy with persistent primary vitreous. Proton density–weighted axial image shows membranous texture of retrolental mass.

 

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