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Research ArticleHead & Neck

Imaging Appearance of the Lateral Rectus–Superior Rectus Band in 100 Consecutive Patients without Strabismus

S.H. Patel, M.E. Cunnane, A.F. Juliano, M.G. Vangel, M.A. Kazlas and G. Moonis
American Journal of Neuroradiology September 2014, 35 (9) 1830-1835; DOI: https://doi.org/10.3174/ajnr.A3943
S.H. Patel
aFrom the Departments of Radiology (S.H.P., M.E.C., A.F.J., G.M.)
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M.E. Cunnane
aFrom the Departments of Radiology (S.H.P., M.E.C., A.F.J., G.M.)
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A.F. Juliano
aFrom the Departments of Radiology (S.H.P., M.E.C., A.F.J., G.M.)
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M.G. Vangel
cBiostatistics Center (M.G.V.), Massachusetts General Hospital, Boston, Massachusetts
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M.A. Kazlas
bOphthalmology (M.A.K.), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
dDepartment of Ophthalmology (M.A.K.), Boston Children's Hospital, Boston, Massachusetts.
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G. Moonis
aFrom the Departments of Radiology (S.H.P., M.E.C., A.F.J., G.M.)
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    Fig 1.

    Schematic representation of orbital connective tissues within the superotemporal orbit. LG indicates lacrimal gland; LLA, lateral levator aponeurosis; LPS, levator palpebrae superioris; LR, lateral rectus muscle; SR, superior rectus muscle.

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    Fig 2.

    MR imaging appearance of the LR-SR band in a 44-year-old woman. Coronal T1-weighted image (A) and coronal STIR image (B) of the left orbit demonstrate the LR-SR band (arrows) as a curvilinear structure extending from the superior margin of the lateral rectus muscle to the lateral margin of the superior rectus/levator palpebrae superioris muscle complex.

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    Fig 3.

    CT appearance of the LR-SR band in a 54-year-old woman. Coronal image of the left orbit demonstrates the LR-SR band (arrow).

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    Fig 4.

    LR-SR band bowing in a 54-year-old woman. Coronal T1-weighted image of the left orbit shows superior bowing of the LR-SR band (arrow), higher than the upper margin of the superior muscle complex.

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    Fig 5.

    MR imaging appearance of the LR-SR band and the lateral levator aponeurosis in a 50-year-old man. Consecutive coronal T1-weighted images of the right orbit, from posterior (A) to anterior (C), show that the lateral levator aponeurosis (white arrows) lies superior and temporal to the LR-SR band (gray arrows) and traverses the lacrimal gland.

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    Fig 6.

    Coronal image of the right orbit from a CISS sequence in a 5-year-old boy displays the LR-SR band (gray arrow) and the lateral levator aponeurosis (white arrow).

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    Fig 7.

    A 65-year-old woman with heavy eye syndrome who presented with high myopia and extreme esotropia (inward eye deviation), resulting in poor peripheral vision. Axial T2WI (A) shows large bilateral staphylomas and esotropia. Coronal T1WI (B) shows thinned/incomplete LR-SR bands (white dashed arrows) stretched over the enlarged globes and nasal displacement of the superior muscle complexes (gray arrows) and inferior displacement of the lateral rectus muscles (white solid arrows).

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    Fig 8.

    A 74-year-old man with B-cell lymphoma. Coronal precontrast T1-weighted image demonstrates lymphoma involving the superotemporal left orbit. Tumor appears to cause inferior bowing/displacement of the LR-SR band but does not definitely transgress it. Note the normal LR-SR band in the right orbit.

Tables

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    Table 1:

    Data per reader

    LR-SR Visible on T1W1aLR-SR Visible on STIRaLR-SR Visible on CTaLR-SR ContinuousbLR-SR BowingcLLA Visibled
    Reader 198%86%63%97%22%79%
    Reader 292%50%76%93%26%85%
    • Note:—LLA indicates lateral levator aponeurosis.

    • ↵a The percentage of cases in which the LR-SR band was visible on the given imaging modality/sequence.

    • ↵b When visible, the percentage of cases in which the LR-SR band formed a continuous structure extending from the superior muscle complex to the lateral rectus muscle (ie, no gaps or discontinuities).

    • ↵c When visible, the percentage of cases in which the LR-SR band demonstrated superotemporal bowing.

    • ↵d The percentage of cases in which the lateral levator aponeurosis was visible, distinct from the LR-SR band.

    • View popup
    Table 2:

    Imaging metrics per patient age quartilea

    Quartile 1Quartile 2Quartile 3Quartile 4P Value
    LR-SR visible on T1W1b96%99%95%90%.03
    LR-SR continuousc95%96%95%91%.40
    LR-SR bowingd19%17%28%34%.03
    LLA visiblee73%77%89%87%.01
    • Note:—LLA indicates lateral levator aponeurosis.

    • ↵a Quartile 1: 9–39 years of age; quartile 2: 40–49 years of age; quartile 3: 50–61 years of age; quartile 4: 62–81 years of age.

    • ↵b The percentage of cases in which the LR-SR band was visible on T1WI.

    • ↵c The percentage of cases in which the LR-SR band was visible as a continuous structure extending from the superior muscle complex to the lateral rectus muscle (ie, no gaps or discontinuities).

    • ↵d The percentage of cases in which the LR-SR band demonstrated superotemporal bowing.

    • ↵e The percentage of cases in which the lateral levator aponeurosis was visible, distinct from the LR-SR band.

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American Journal of Neuroradiology: 35 (9)
American Journal of Neuroradiology
Vol. 35, Issue 9
1 Sep 2014
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S.H. Patel, M.E. Cunnane, A.F. Juliano, M.G. Vangel, M.A. Kazlas, G. Moonis
Imaging Appearance of the Lateral Rectus–Superior Rectus Band in 100 Consecutive Patients without Strabismus
American Journal of Neuroradiology Sep 2014, 35 (9) 1830-1835; DOI: 10.3174/ajnr.A3943

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Imaging Appearance of the Lateral Rectus–Superior Rectus Band in 100 Consecutive Patients without Strabismus
S.H. Patel, M.E. Cunnane, A.F. Juliano, M.G. Vangel, M.A. Kazlas, G. Moonis
American Journal of Neuroradiology Sep 2014, 35 (9) 1830-1835; DOI: 10.3174/ajnr.A3943
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