ABSTRACT
BACKGROUND: Lymphangioma is a vascular tumor of the orbit with a propensity for recurrent hemorrhage. These tumors may be difficult to diagnose in young patients who present with sudden proptosis due to hemorrhage into a previously unrecognized lesion. Magnetic resonance imaging (MRI) should be ideally suited for evaluating lymphangioma due to the unique ability of MRI to characterize hemorrhage because of the paramagnetic qualities of hemoglobin. METHODS: The authors performed T1-, T2-, and proton density-weighted MRI on 12 patients with orbital lymphangioma. Six patients underwent MRI with gadolinium-DTPA contrast enhancement. The MRI studies were performed using a 1.5 Tesla super-conducting magnetic resonance unit, except for 3 early studies performed with a 0.5 Tesla unit. All studies were performed with orbital surface coil imaging. Computed tomography (CT) was performed in 10 patients. RESULTS: Tumor was visible on MRI in all 12 patients. Magnetic resonance imaging delineated clearly the internal structure of subacute and chronic hemorrhagic cysts, and differentiated between these tumors because of the different paramagnetic qualities of subacute hemorrhage compared to chronic hemorrhage. In two patients, MRI detected large tumor feeding vessels by the flow void phenomenon unique to MRI. Computed tomography did not detect these vessels. Gadolinium-contrasted T1-weighted MRI did not further delineate or characterize the tumor. CONCLUSION: Magnetic resonance imaging is the modality of choice for imaging orbital lymphangioma because of its unequalled differentiation of hemorrhagic cysts, and its unique ability to detect tumor feeding vessels by the flow void phenomenon.
Subject(s)
Lymphangioma/diagnosis , Magnetic Resonance Imaging , Orbital Neoplasms/diagnosis , Organometallic Compounds , Pentetic Acid , Contrast Media , Gadolinium , Gadolinium DTPA , Humans , Tomography, X-Ray ComputedABSTRACT
Magnetic resonance imaging (MRI) is very useful in the evaluation of ocular and orbital disease. Heavy metal particles, used in the pigment base of mascara and eyelining tattoos, have a paramagnetic effect that causes alteration of the local magnetic field in adjacent tissues. These changes in normal signal result in distortion of the globes. In some cases, the distortion may mimic actual ocular disease such as a ciliary body melanoma or cyst.
Subject(s)
Cosmetics/adverse effects , Eyelids , Magnetic Resonance Imaging , Tattooing , Female , HumansABSTRACT
The history of radiography and orbital imaging begins in 1895 with Wilhelm Roentgen's discovery of x-rays. Over the next three quarters of a century, radiographic pioneers like Dr. William Sweet, who developed the Sweet method, and Dr. George E. Pfahler, who made the first successful pictures of a brain tumor, helped to bring radiography into the 20th century. With each new radiologic innovation producing a forward surge followed by a period of refinement, new methods were invented and utilized to their diagnostic limits. But perhaps none of the radiologic innovations of this century--the Coolidge tube, the Potter-Bucky diaphragm, tomography and angiography-will have more impact than computed tomography and magnetic resonance imaging.
Subject(s)
Eye/diagnostic imaging , Ophthalmology/history , Orbit/diagnostic imaging , Europe , History, 19th Century , History, 20th Century , Radiography , United StatesABSTRACT
Professor Roentgen presented the roentgen ray in 1895. The subsequent history of radiology is characterized not by steady, but by stepwise advancement. Each new innovation produced a forward surge followed by a period of refinement in which the new method was developed and exploited to the very limits of its diagnostic yield.
