[Differential diagnosis of intraconal orbital masses using high-resolution MRI with surface coils in 78 patients].

PURPOSE

Over the last decade, MRI has become the standard procedure for the diagnosis of orbital masses. Purpose of the study was to evaluate criteria for differential diagnosis for intraconal masses on MRI in a large patient group.

MATERIAL AND METHODS

In a retrospective study, MR examinations of 78 patients with intraconal masses were evaluated. All examinations were performed using surface coils for high spatial resolution. Signal behavior on T2-WI and T1-WI before and after contrast application as well as further tumor characteristics (i. e., shape, size, position, delineation and infiltration) were evaluated. Every diagnosis was proven by histopathological results from extirpation (n = 18) or biopsy (n = 22), or confirmed by other imaging modalities (n = 13) or clinical course (n = 25).

RESULTS

Different tumor characteristics are helpful in the differentiation between cavernous hemangioma, lymphangioma, varices, AV malformations and solid tumors. Due to overlapping in the imaging appearance, the differentiation between inflammatory pseudotumor, lymphoma and orbital metastasis was more difficult.

CONCLUSION

While high resolution MRI using surface coils allows differentiation between the typical vascular tumors, the differentiation between solid tumors is more difficult. Thus, a histopathologic verification of the diagnosis is necessary in solid tumors.