CT/MRI Orbits & Sinuses
CT/MRIVaries
EDOutpatient
All imaging requests must be justified by an IR(ME)R practitioner (radiologist or radiographer)CT orbits — ED
— ANY of the following
- Suspected orbital/sinus fracture — thin-section ≤1 mm with coronal reformats
- Suspected orbital cellulitis or subperiosteal abscess (sight-threatening)
- Suspected intraorbital foreign body — mandatory before MRI
- Suspected globe rupture or penetrating orbital injury
- Acute sinusitis with orbital or intracranial extension — contrast-enhanced CT
MRI orbits — Outpatient
— ANY of the following
- Optic neuritis (linked to MS; NG220)NICE NG220
- Orbital tumours and inflammatory conditions
- Thyroid eye disease: MRI preferred for extraocular muscle and optic nerve assessmentNICE NG145
CT sinuses — Outpatient
— ANY of the following
- Pre-FESS for chronic rhinosinusitis — ONLY after ≥8 weeks medical therapy failed
- Plain sinus X-rays ABOLISHED from RCR iReferRCR iRefer
MRI sinuses — Outpatient
— ANY of the following
- Suspected sinonasal tumour
- Superior for skull base and intracranial involvement
Notes
Warning
If MRI considered, pre-MRI check for metallic intraorbital foreign body mandatory
Removed
Plain sinus X-rays abolished from RCR iRefer
RCR iReferInformation
MRI preferred for soft tissue orbital pathology
Change Log
v1.02026-03-05Initial publication (CT only)
v2.02026-03-08MRI orbits and sinuses added. Expanded to cover outpatient indications.