Noninvasive Dynamic Magnetic Resonance Angiography With Time-Resolved Imaging of Contrast KineticS (TRICKS) in the Evaluation of Orbital Vascular Lesions

Abstract

To evaluate the clinical utility of timeresolved contrast-enhanced magnetic resonance angiography (MRA) in the evaluation of vascular orbital tumors. Methods: Retrospective medical record review of patients with vascular orbital lesions imaged with Time-Resolved Imaging of Contrast KineticS (TRICKS; GE Healthcare [Chalfont St Giles, England]) MRA, a noninvasive dynamic imaging modality. Results: Five patients with orbital vascular tumors were evaluated using TRICKS MRA. These included 1 patient with a cavernous hemangioma, 2 patients with orbital varices, 1 patient with an orbitocutaneous arteriovenous mal-formation, and 1 patient who had a solitary fibrous tumor with features of a hemangiopericytoma. In 2 patients, diagnoses were altered as a result of TRICKS MRA. In addition, a young patient with a large orbitocutaneous arteriovenous malformation involving the ophthalmic artery was followed perioperatively and noninvasively using TRICKS MRA, which produced exquisite images and added substantial value in the care of these patients. Conclusion: Dynamic MRA in the form of TRICKS is a newly available imaging modality with great potential for improving the evaluation and management of patients with complex orbital tumors.

Cavernous venous malformations of the orbit (so-called cavernous haemangioma): a comprehensive evaluation of their clinical, imaging and histologic nature

“…This pattern is characteristic of a slow flow venous malformation without arterio-venous shunting or distensible components 19. Studies of time-resolved MRI sequences20 and older direct venography1 confirm this claim. These features can be useful in discriminating them from true neoplasms, such as schwannoma, haemangiopericytoma or solitary fibrous tumours 20 21…”

“…In fact, our finding of focal/multifocal inflow in the late arterial phases is suggestive of some arterial component. Additionally, both earlier arteriography studies1 and more modern Time-Resolved Imaging of Contrast KineticS (TRICKS)20 MRI imaging series have demonstrated small puddles of contrast in the arterial phase. However, despite these suggestive flow dynamics, arterial elements are not evident histologically.…”

Orbital lymphaticovenous malformations: Current and future treatments

“…Dynamic contrast-enhanced MRI angiography may potentially be used to evaluate the response to Valsalva. 79,137 However, this technique currently does not provide the same level of relevant dynamic detail as Valsalva-augmented venous phase multidetector CT angiography because of the long acquisition times necessary for MRI and the decreased spatial resolution.…”

Spontaneous Resolution of Two Dural Carotid-Cavernous Fistulas Presenting With Optic Neuropathy and Marked Congestive Ophthalmopathy

“…Other advantages are relatively high signal-to-noise-ratio and data acquisition in any orientation, independent of direction and rate of flow (24). TRICKS has also been useful in the imaging and management of arteriovenous malformations and tumors with high flow rates such as hemangiopericytomas (26)(27)(28).…”