Glass foreign bodies

Glasscherben
in der Fußsohle im Röntgenbild.
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Imaging
foreign bodies in head and neck trauma: a pictorial review. Broken water glass. Coronal CT sections (a, b) and 3-dimensional volume rendering (c) displaying intraorbital hyperdense foreign objects (arrows) in close proximity to the globe and the inferior oblique muscle (a) and inside the infratemporal fossa, protruding into the maxillary sinus and orbital cavity (b). Pronounced hyperdensity of the glass objects enables their differentiation from dislocated bone fragments (arrowhead). Also note intraorbital-subperiosteal haematoma (asterisk)
insightsimaging.springeropen.com • CC-by-4.0
Imaging
foreign bodies in head and neck trauma: a pictorial review. Broken ophthalmic lens. Axial (a) and coronal (b) CT images showing a hyperdense foreign object (arrow) in the right buccal area surrounded by haematoma. Photograph of a translucent piece of glass after surgical retrieval (c)
insightsimaging.springeropen.com • CC-by-4.0
Imaging
foreign bodies in head and neck trauma: a pictorial review. Glass bottle fragment. Axial contrast enhanced CT image (a) and corresponding anteroposterior scout scan (b) displaying a hyperdense structure (arrow) in the right posterior cervical space dorsolateral to the sternocleidomastoid muscle. At first glance, this object could look like a metal fragment (compare Fig. 7b). Careful comparison, however, reveals a lack of streak artefacts in CT images which would be expected in metallic objects of this size
insightsimaging.springeropen.com • CC-by-4.0
Dünner
Glassplitter im Weichteil der Hand. Nicht alle Glasarten sind röntgendicht, also im Röntgen zu sehen. Besonders gut ist Bleiglas zu sehen.
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Hohlfuß und
Glassplitter in Fußsohle
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Glassplitter
in Fußsohle
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Glasscherben
dorsal im Weichteil des Fingers und zusätzlich Endgliedfraktur ohne größerer Verschiebung.
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Radiopaedia • CC-by-nc-sa 3.0 • de

Glass foreign bodies may be present if they are ingested, inserted, or as a result of an injury. All glass is radiopaque .

Epidemiology

The prevalence of glass foreign bodies in wounds from injury has been recorded at a rate of 1.5% in superficial (subcutaneous) wounds and 7.5% of deeper wounds . They make up ~15% (range 9-24%) of all retained foreign bodies .

Radiographic features

Plain radiograph

Only ~10% of x-rays ordered for investigation of retained foreign bodies are positive (reflecting the low incidence post-injury), but x-rays are excellent at detecting radiopaque foreign bodies with ~85% being detected :

  • glass is always radiopaque, independent of lead content or other additives, with the caveat that tiny pieces may be too small to actually be resolved (see below) 
  • should be visible on plain films if larger than 2 mm
CT

All glass is visible on CT and usually easier to see than on plain radiography . Density varies between 500-1900 HU. Dense fragments as small as 0.01 mm can be detected .

Ultrasound
  • can be used to localize foreign bodies further and define the relationship with soft tissue structures and assess for further injuries
  • appears hyperechoic with posterior acoustic shadowing and often demonstrates reverberation artifact 
  • if present for >24 hours may demonstrate a hypoechoic ring
MRI

MRI would clearly not be the first choice investigation for detecting foreign bodies, including glass. Nevertheless, on MRI all forms of glass are seen but on most sequences considerable artifact is present .

Signal characteristics
  • T1: low signal
  • T2: low signal
  • T2*: blooming artifact
  • T1C+: linear enhancement if a foreign body granuloma has formed
Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Fremdkörper Glas:
Fremdkörper
durch Verletzungen
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Fremdkörper
 
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Keramiksplitter
 
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