MR Dacryocystography in the Evaluation of Patients with Obstructive Epiphora Treated by Means of Interventional Radiologic Procedures

Coşkun, Bilgen; Ilgıt, Erhan; Önal, Baran; Konuk, Onur; Erbaş, Gonca

doi:10.3174/ajnr.a2889

Cited by 21 publications

(7 citation statements)

References 26 publications

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“…14,30 The topical instillation of diluted gadolinium solution is usually well-tolerated, but it still represents an off-label use. 21,28,[30][31][32] Saline solution has a lower viscosity than diluted gadolinium, thus allowing a more physiological examination, causing less irritation in the mucosal structures and no discomfort or adverse effects, 8 as also demonstrated in our study.…”

Section: Discussionsupporting

confidence: 59%

“…The topical instillation of diluted gadolinium solution is usually well-tolerated, but it still represents an off-label use. 21,28,30–32…”

Section: Discussionmentioning

confidence: 99%

“…8 Magnetic resonance (MR) dacryocystography with or without gadolinium administration has been increasingly used, as it does not involve ionizing radiation exposure, allows the identification of lacrimal drainage pathway obstruction and its level, and is characterized by a high-contrast resolution. 19,21 Dynamic MR examinations through the execution of timeresolved angiography with interleaved stochastic trajectories (TWIST) 22 or dynamic recalled three-dimensional spoiled gradient (3DSPGR) 23 sequence demonstrated their ability to visualize real-time contrast flow through the lacrimal drainage system, from the lacrimal sac to nasolacrimal duct and finally inferior meatus, providing functional information.…”

mentioning

confidence: 99%

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

et al. 2022

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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.

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Section: Discussionsupporting

confidence: 59%

“…The topical instillation of diluted gadolinium solution is usually well-tolerated, but it still represents an off-label use. 21,28,30–32…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

et al. 2022

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“…MRD imaging with topical instillation of gadolinium has been explored by different researchers (14)(15)(16)(17). Studies on topical application of 1:100 diluted gadobutrol solutions demonstrated none of the adverse effects experienced with the contrast media during and immediately after the instillation (17).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of epiphora by topical contrast-enhanced CT and MR dacryocystography: which one to choose?

Singla¹,

Ballal

Sridhara

et al. 2022

Acta Radiol

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Background Our study aims to compare non-invasive imaging such as topical computed tomography dacryocystography (CTD) and topical magnetic resonance dacryocystography (MRD) in patients with epiphora. Purpose To evaluate the practicability of topical contrast media during helical CTD and topical saline during MRD to reveal obstruction in the nasolacrimal drainage system (NLDS). Material and Methods Twenty participants with nasolacrimal duct obstruction were observed for two years. Ten participants underwent CTD and the other 10 participants underwent MRD. Images were analyzed by two radiologists. Participants were also asked about the level of discomfort of the contrast material versus the saline solution. Results The NLDS was seen on both CTD and MRD. Very good agreement between the two observers (κ value > 0.81) was seen according to the κ statistics. CTD multiplanar and 3D images allowed for precise diagnosis of the point of obstruction whereas, the MRD did not require any contrast material and showed the point of obstruction. Saline was more comfortable for the patients than topical contrast ( P < 0.05). Conclusion Topical CTD and MRD are non-invasive techniques that can visualize the degree and level of obstruction in the NLDS than conventional invasive cannulation dacryocystography. CTD is useful in visualizing the point of obstruction and smaller drainage structures. However, it is a source of ionizing radiation to the lens. The benefit of MRD is that it requires no contrast or radiation; however, it is poor in depicting the bone anatomy and smaller drainage structures. Finally, saline was better tolerated by patients than topical contrast

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“…Although DCGs carry radiation exposure, only 0.0011 to 0.0046Gy (17) is delivered to the lens. In contrast, detectable lens opacities occur from over 100 times this level, at 0.5-2Gy and cataracts occur from 5Gy (18).…”

Section: Bene Ts Of Dcgsmentioning

confidence: 99%

Recurrent Epiphora After Dacryocystorhinostomy Surgery: Structural Abnormalities Identified With Dacryocystography and Long Term Outcomes of Revision Surgery.

Timlin

Kang

Jiang

et al. 2021

Preprint

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Background: To investigate the aetiopathology of recurrent epiphora or stickiness after dacryocystorhinostomy (DCR) surgery, identifiable on dacryocystography (DCG), and to assess the success rates of secondary corrective surgeries.Methods: Consecutive post-DCR DCG images from patients with recurrent symptoms were reviewed between 2012-2015.Results: 159 eyes of 137 patients were evaluated. 58 DCGs showed normal postoperative findings, 4 an upper/lower canalicular block, 13 a common canalicular block, 31 a completely closed anastomosis, 50 a narrow anastomosis, and 3 an anastomosis draining into a nasal sinus.The most successful corrective procedures for each failure category were: Lester Jones Tube (LJT) for a normal post-operative DCG (17/18 success), Sisler trephination with tubes for upper/lower canalicular block (1/2 success), redo-DCR with tube for common canalicular blockage (5/6 success), redo-DCR +/- tube for completely closed anastomosis (12/16 success), LJT followed by redo-DCR +/- tube for narrow surgical anastomosis (1/1 and 17/27 success respectively), and redo-external-DCR with tube for anastomosis into a nasal sinus (1/1 success). Redo-DCR was ineffective in patients who had good post-DCR anatomical patency (22% success).Conclusion: This is the first study to report success rates of redo-DCR surgery according to anatomical findings confirmed by DCG. The outcome flow diagram help clinicians recommend procedures that are most likely to be successful for their patient’s specific anatomical abnormality. It also provides a visual tool for the shared decision-making process. Notably, symptomatic patients with a normal DCG post DCR are unlikely to benefit from redo-DCR, with a LJT being the recommended next step.

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MR Dacryocystography in the Evaluation of Patients with Obstructive Epiphora Treated by Means of Interventional Radiologic Procedures

Cited by 21 publications

References 26 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 epiphora by topical contrast-enhanced CT and MR dacryocystography: which one to choose?

Recurrent Epiphora After Dacryocystorhinostomy Surgery: Structural Abnormalities Identified With Dacryocystography and Long Term Outcomes of Revision Surgery.

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