Digital Subtraction Macrodacryocystography

Galloway, Jerry E.; Kavic, Thomas A.; Raflo, Gary T

doi:10.1016/s0161-6420(84)34220-8

Cited by 52 publications

(3 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…First, it uses no ionizing radiation. As the lens is one of the most susceptible tissues to ionizing radiation, its exposure to radiation should be avoided, also considering that the radiation exposure to the eye lens in conventional dacryocystography has been estimated to be 2.7 mG. 34 Second, it does not require local anesthesia, or cannulation of the punctum, therefore eliminating the risk of iatrogenic trauma on the punctum. Third, no injection of viscous contrast media is required, thus avoiding the risk of local or system side effects 19 reducing the timing and costs of the examination.…”

Section: Discussionmentioning

confidence: 99%

Non-contrast MR dacryocystography for the evaluation of epiphora and recurrent dacryocystitis: A preliminary study

et al. 2022

View full text Add to dashboard Cite

Introduction Obstruction of the lacrimal drainage represents a common ophthalmologic issue. The blockage may interest any level of the lacrimal drainage pathway, and it is important to find the site of obstruction to plan the most appropriate treatment. In this study, findings from magnetic resonance (MR) dacryocystography were compared with findings from endoscopic and surgical procedures to evaluate the accuracy of MR dacryocystography in localizing the site of nasolacrimal duct obstruction. Methods We enrolled twenty-one patients with clinical suspicion of nasolacrimal duct obstruction who underwent dacryoendoscopy and surgery. MR dacryocystography was performed with a heavily T2-weighted fast spin echo sequence in the coronal planes. Before the MRI was performed, a sterile 0.9% NaCl solution was administered into both conjunctival sacs. For each examination, two independent readers (with 8 and 10 years of experience in head and neck imaging) evaluated both heavily 3D space T2-weighted and STIR sequences. Results Stenosis/obstruction of nasolacrimal duct or lacrimal sac was diagnosed in all 21 patients who underwent MRI dacryocystography. In particular, the site of the obstruction was classified as lacrimal sac in 12 (57%) patients, nasolacrimal duct in 6 (29%) patients, and canaliculi in 3 (14%) patients by both readers. By comparison with the evidence resulting from the endoscopy, there were differences between MRI dacryocystography and dacryoendoscopy in the evaluation of the obstruction’s site in three patients, with an overall accuracy of 85.7%. Conclusion MR dacryocystography allows a non-invasive evaluation of the lacrimal drainage pathway, valid for the planning of the most appropriate treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Non-contrast MR dacryocystography for the evaluation of epiphora and recurrent dacryocystitis: A preliminary study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Determining the occlusion level before the operation increases the success of both minimally invasive methods and DCR (13). The optical lens is highly sensitive to radiation (14) In DCG, the optical lens is exposed to a dose of about 2.7 mGy. In DSG, the optical lens is exposed to a radiation dose of about 0.014-0.021 rad.…”

Section: Tablementioning

confidence: 99%

Evaluation of Distal Occlusions accompanying Punctal Stenosis using Radionuclide Imaging in patients with Unilateral Epiphora

Ceylan

Yilmaz

2023

Med Sci Discov

View full text Add to dashboard Cite

Objective: Our objective was to evaluate distal occlusions accompanying punctal stenosis, which can lead to impaired nasolacrimal drainage in patients with punctal stenosis, using radionuclide imaging. Material and Methods: Our study enrolled 42 patients who had unilateral punctal stenosis and experienced epiphora on the same side. None of the patients had previously undergone surgical intervention for this condition. Ophthalmological examination results were normal on the unaffected side. Dacryoscintigraphy was performed bilaterally, and specific regions of interest were identified. The scintigraphic images were assessed quantitatively and qualitatively by two nuclear medicine specialists. Evaluation between the nuclear medicine specialists was conducted using the McNemar Bowker test and the Kappa test. Results: Eighty-one percent (34) of the patients were female. The mean age of the patients was 68.23±9.67 years. In patients with punctal stenosis, the punctal area exhibited edematous features. The lacrimal drainage pathway from the punctum was assessed by two nuclear medicine specialists using two different methods. In the visual quantitative evaluation to determine the localization of the stenosis, there was a low to moderate agreement between the two observers (p=0.018, kappa value=0.252). In the quantitative evaluation, there was excellent agreement between the observers (p=0.0001, kappa value=1). Conclusion: Dacryoscintigraphy is preferred as an imaging method due to its non-invasive nature that does not disturb the physiological processes. It offers advantages such as lower radiation exposure and higher patient compliance compared to dacryocystography. However, it should be noted that the anatomical correlation in dacryoscintigraphy is relatively low compared to radiological methods. By incorporating quantitative data into the visual assessment of dacryoscintigraphy, it may be possible to enhance anatomical correlation and improve observer agreement, particularly in patients presenting with a combination of functional and anatomical obstructions.

show abstract

“…More sophisticated computer-assisted digital subtraction images can be produced using fl uoroscopically controlled angiographic equipment and an image intensifi er. 8,9 The dacryocystogram of a normal lacrimal drainage system will usually show the canaliculi when less viscous aqueous contrast media are used. The sac appears as a smooth, straight, or gently curved passage with the concavity facing laterally.…”

Section: Contrast Dacryocystographymentioning

confidence: 99%

Imaging and Clinical Evaluation of the Lacrimal Drainage System

Dutton

White

The Lacrimal System

View full text Add to dashboard Cite

The lacrimal drainage system is an intricate mucous membrane-lined conduit, the function of which depends on a complex interplay of anatomy and physiology. Appropriate drainage of tears depends on several factors, including the volume of tear production, eyelid position, normal pump mechanisms, anatomic status of the drainage passages, gravity, and nasal air convection currents. The patient with symptomatic epiphora may have a normal anatomic system overwhelmed by an oversecretion syndrome, or a drainage system that is anatomically compromised and therefore unable to handle normal tear production. Conversely, patients may have partial or complete blockage of the nasolacrimal system but experience no symptoms or have symptoms of dry eye if tear production is signifi cantly reduced. The clinical picture of bothersome epiphora thus depends on the balance of tear production and tear drainage, not on the absolute function of either one.The etiologies of lacrimal drainage dysfunction can be divided into two categories, anatomic and physiologic. Anatomic obstruction refers to a gross structural abnormality of the nasolacrimal system. This can be a complete obstruction, such as punctal occlusion, canalicular blockage, or nasolacrimal duct fi brosis. The causes of partial obstruction include punctal or canalicular stenosis, infl ammatory narrowing of the duct, or mechanical obstruction within the lacrimal sac, such as tumors or stones. Physiologic etiologies result from failure of functional mechanisms despite normal anatomy. These types of dysfunction may result from anatomic deformity, such as punctal eversion or other eyelid malposition, or from lacrimal pump inadequacy from poor orbicularis tone or eyelid laxity.1 Determining the type of dysfunction and the exact location of the anatomic blockage with physical examination and ancillary testing are essential if appropriate therapy is to be offered.The clinical evaluation of gross lacrimal function is usually not diffi cult and the diagnosis of epiphora can oftentimes be made largely on history alone. However, determination of the etiology of epiphora may be more diffi cult and often requires a variety of diagnostic procedures.

show abstract

Digital Subtraction Macrodacryocystography

Cited by 52 publications

References 7 publications

Non-contrast MR dacryocystography for the evaluation of epiphora and recurrent dacryocystitis: A preliminary study

Non-contrast MR dacryocystography for the evaluation of epiphora and recurrent dacryocystitis: A preliminary study

Evaluation of Distal Occlusions accompanying Punctal Stenosis using Radionuclide Imaging in patients with Unilateral Epiphora

Imaging and Clinical Evaluation of the Lacrimal Drainage System

Contact Info

Product

Resources

About