Predictability of Magnetic Resonance Imaging in Differentiation of Orbital Lymphoma from Orbital Inflammatory Syndrome

Cytryn, Albert S.; Putterman, Allen M.; Schneck, G; Beckman, Enrico; Valvassori, Galdino E.

doi:10.1097/00002341-199706000-00007

Cited by 39 publications

(25 citation statements)

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“…Typically, OIS lesions are described as isointense to extraocular muscle on T1-weighted images but can show variability, which is consistent with our findings. 2,3,6 T2 signal intensity in OIS lesions was less predictable, both in this study and in the literature. 2 OIS lesions showed contrast enhancement, consistent with the literature.…”

Section: Discussioncontrasting

confidence: 61%

“…6,19,20 Lesions have been previously described as isointense to extraocular muscle and hypointense to orbital fat on T1, with enhancement postcontrast. 6,19,20 We typically noted isointensity to extraocular muscle and variable contrast enhancement. Hyperintensity to extraocular muscle on T2 has been previously described and was consistent with our results.…”

Section: Discussionmentioning

confidence: 99%

“…Previous descriptive analyses comparing OIS and lymphoma, and comparing OIS and orbital cellulitis on MR imaging, did not show differences specific enough for differentiating these diseases. 2,6 …”

mentioning

confidence: 99%

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MR Imaging of Orbital Inflammatory Syndrome, Orbital Cellulitis, and Orbital Lymphoid Lesions: The Role of Diffusion-Weighted Imaging

Kapur

Sepahdari²,

Mafee³

et al. 2008

AJNR Am J Neuroradiol

158

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BACKGROUND AND PURPOSE Orbital inflammatory syndrome (OIS) has clinical features that overlap with orbital lymphoid lesions and orbital cellulitis. Prompt diagnosis is needed in all 3 conditions because the management of each one differs greatly. CT and MR imaging, though useful, do not always distinguish among these conditions. The aim of this study was to identify the role of diffusion-weighted imaging (DWI) in differentiating these 3 diagnoses. MATERIALS AND METHODS A retrospective analysis of orbital MR imaging was conducted. T1- and T2-weighted and postcontrast images were analyzed. Region-of-interest analysis was performed by using measurements in areas of abnormality seen on conventional MR imaging sequences and measurements of the ipsilateral thalamus for each patient. The DWI signal intensity of the lesion was expressed as a percentage of average thalamic intensity in each patient. Similarly, lesion apparent diffusion coefficients (ADCs) and lesion-thalamus ADC ratios were calculated. Statistical significance was determined by the Kruskal-Wallis test, and post hoc pairwise comparisons, by the Mann-Whitney U test for DWI-intensity ratio, ADC, and ADC ratio. RESULTS A significant difference was noted in DWI intensities, ADC, and ADC ratio between OIS, orbital lymphoid lesions, and orbital cellulitis (P < .05). Lymphoid lesions were significantly brighter than OIS, and OIS lesions were significantly brighter than cellulitis. Lymphoid lesions showed lower ADC than OIS and cellulitis. A trend was seen toward lower ADC in OIS than in cellulitis (P = .17). CONCLUSIONS DWI may help differentiate OIS from lymphoid lesions and cellulitis and may allow more rapid management.

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Section: Discussioncontrasting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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MR Imaging of Orbital Inflammatory Syndrome, Orbital Cellulitis, and Orbital Lymphoid Lesions: The Role of Diffusion-Weighted Imaging

Kapur

Sepahdari²,

Mafee³

et al. 2008

AJNR Am J Neuroradiol

158

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“…Dynamic contrast-enhanced MRI scans may show more specific characteristics, which may distinguish them from other diseases. 16,17 The contrast index (CI) curves of orbital lymphomas display relatively rapid increases, reach a maximum CI at 45~120 sec, and decrease rapidly in most cases. The majority of maximum CIs are less than 2.0.…”

Section: -8mentioning

confidence: 99%

CT and MRI features of Primary Orbital Lymphoma: review of 14 cases

et al. 2011

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Objective: To assess the computed tomography (CT) imaging and magnetic resonance imaging (MRI) features of primary orbital lymphoma and to establish a differential diagnosis. Material & Methods:Fourteen patients (9 male and 5 female) suffering from primary orbital lymphoma underwent CT scanning with and without contrast. Pre-and post-contrast MRI scans were performed in 10 patients. Their ages ranged from 1.5 to 65 years (average age: 36 years). The course of diseases varied from 2 months to 16 years. Results:The diagnosis was confirmed pathologically in all cases. Lesions were bilateral in 4 cases and unilateral in 10 cases. Periorbital preseptal tissues were involved mainly in the upper lateral quadrant of the orbit. Focal masses were observed in 5 patients. Lesions that infiltrated the lacrimal gland, adjacent extraocular muscles and intraorbital tissues, along with the extraocular muscles, were found in other patients. The tumors that had advanced into intraorbital tissues and had involved extraocular muscles, displayed either a "casting sign" or a "ring sign". Isodense soft-tissue masses with clear demarcation were found on plain CT film and lesions displayed low to intermediate signal intensity on T1-weighted MRI and relatively low or high signal intensity on T2-weighted MRI. The lesions demonstrated homogeneously marked enhancement on CT and MRI with contrast medium. Conclusion:CT imaging and MRI -particularly MRI -can demonstrate the location, configuration, inner structure and characteristic manifestations of the orbital lymphomas. This may assist the pre-operative diagnosis of these lesions.

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“…Orbital lymphoma can be very difficult to distinguish from orbital pseudotumor, however the lymphoma is usually seen with decreased density on delayed images in dual-phase-spiral CT contrast, and orbital pseudotumor is mostly seen with increased density on delayed images in dual-phase CT contrast [53]. Orbital lymphoma is also typically seen with a brighter DWI signal and lower apparent diffusion coefficient (ADC) than normal orbital structures and orbital pseudotumor is seen with intermediate DWI and ADC signal, similar to normal lacrimal gland [54]. We evaluated the diagnostic relationship between radiological diagnosis and pathological diagnosis.…”

Section: Orbital Lymphomamentioning

confidence: 99%

Valuation of Four-Quadrant Location Method in Diagnosis and Differential Diagnosis of the Orbital Tumor by Comparison Study Combining CT and MRI with Pathology

Akter¹,

Hasan²,

Sana³

et al. 2017

J Pain Relief

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Purpose: To valuate four-quadrant location method in diagnosis and differential diagnosis of the orbital tumor by comparison study combining CT and MRI with pathology. Materials and methods:Data of 87 patients (44 female and 43 males), aged 1 to 84 years were recruited in this study, including the computed tomography(CT), Magnetic resonance imaging (MRI), and histopathology diagnosis. All orbital tumors were verified radiologically and pathologically in the Hospital of Jinggangshan University from Sep-2008 to April-2016 patients underwent CT scanning (31 Conventional CT and 18 dynamic contrast enhancements CT) and 38 patients underwent MR Imaging (35 dynamic contrast enhancement MRI and 3 conventional MRI). The clinical data were retrieved from the medical record. We classified the orbital region according to four-quadrant and eight-space (FQES) division and traditional muscleconal division with center point of optic nerve. Results:Among the 87 cases of the orbital tumors, 70 cases (80.45%) were orbital benign tumors and 17 cases (19.54%) were malignant tumors. Regarding the location of the orbit, 41 lesions (47.12%) were in superolateral, 18 lesions (20.68%) were in inferolateral, 16 lesions (18.39%) were in inferomedial, 8 lesions (9.19%) were in superomedial, 3 lesions (3.44%) were in globe, 1 lesion (1.14%) was in optic nerve. The most common tumors are hemangiomas (total 36 cases: 12 in inferolateral, 8 in inferomedial, 9 in superolateral, 7 in superomedial) and 9 cases of pleomorphic adenoma were in superolateral, 9 cases of dermoid cyst ( 7 in superolateral and in 2 inferomedial), 5 cases of inflammatory pseudotumor (4 in superolateral and 1 in inferomedial), 7 cases of lymphoma (3 in superolateral, 2 in inferolateral and 2 in inferomedial ), 3 cases of adenoid cystic carcinoma in superolateral, 3 caese solitary fibrous tumor ( 2 in suprolateral and 1 in inferomedial), 3 cases lipoma (1 in superomedial, 1 in superolateral and 1 in inferolateral), 2 cases choroidal melanoma were in globe, 1 case of metastasis in superolateral, 1 case of meningioma in optic nerve, 1 case of malignant melanoma was in superolateral. The orbital tumors appeared in orbit with mostly regular, oval and rounds shape, well defined margin. The size ranged from 0.8 mm × 4.5 cm to 4.5 cm × 2.0 cm. The CT revealed iso-density in 22, slightly high-density in 15, mixed density in 6, low density in 5 and high density in 1 lesion. Among them, 18 were contrast enhancements. On T1WI image, the MRI revealed low signal intensity in 23 cases, slightly low signal in 4 cases, iso signal intensity in 7 case, high signal intensity in 3 cases, mixed signal intensity in 1 case on T2WI, it revealed high signal intensity in 23 cases, slightly high intensity in 7 cases, low signal intensity in 4 cases, iso signal intensity in 3 cases, mixed signal intensity in 1 case. Among them, 35 contrast enhancement MRI and 3 were non contrast MRI. Benign tumor was diagnosed in 70 patients, of them 34 were male and 36 were female, and the mean age was 45.19 ...

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Predictability of Magnetic Resonance Imaging in Differentiation of Orbital Lymphoma from Orbital Inflammatory Syndrome

Cited by 39 publications

References 0 publications

MR Imaging of Orbital Inflammatory Syndrome, Orbital Cellulitis, and Orbital Lymphoid Lesions: The Role of Diffusion-Weighted Imaging

MR Imaging of Orbital Inflammatory Syndrome, Orbital Cellulitis, and Orbital Lymphoid Lesions: The Role of Diffusion-Weighted Imaging

CT and MRI features of Primary Orbital Lymphoma: review of 14 cases

Valuation of Four-Quadrant Location Method in Diagnosis and Differential Diagnosis of the Orbital Tumor by Comparison Study Combining CT and MRI with Pathology

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