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Agarwal K, Vinekar A, Chandra P, Padhi TR, Nayak S, Jayanna S, Panchal B, Jalali S, Das T. Imaging the pediatric retina: An overview. Indian J Ophthalmol 2021; 69:812-823. [PMID: 33727440 PMCID: PMC8012979 DOI: 10.4103/ijo.ijo_1917_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Recent decade has seen a shift in the causes of childhood blinding diseases from anterior segment to retinal disease in both developed and developing countries. The common retinal disorders are retinopathy of prematurity and vitreoretinal infections in neonates, congenital anomalies in infants, and vascular retinopathies including type 1 diabetes, tumors, and inherited retinal diseases in children (up to 12 years). Retinal imaging helps in diagnosis, management, follow up and prognostication in all these disorders. These imaging modalities include fundus photography, fluorescein angiography, ultrasonography, retinal vascular and structural studies, and electrodiagnosis. Over the decades there has been tremendous advances both in design (compact, multifunctional, tele-consult capable) and technology (wide- and ultra-wide field and noninvasive retinal angiography). These new advances have application in most of the pediatric retinal diseases though at most times the designs of new devices have remained confined to use in adults. Poor patient cooperation and insufficient attention span in children demand careful crafting of the devices. The newer attempts of hand-held retinal diagnostic devices are welcome additions in this direction. While much has been done, there is still much to do in the coming years. One of the compelling and immediate needs is the pediatric version of optical coherence tomography angiography. These needs and demands would increase many folds in future. A sound policy could be the simultaneous development of adult and pediatric version of all ophthalmic diagnostic devices, coupled with capacity building of trained medical personnel.
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Affiliation(s)
- Komal Agarwal
- Srimati Kanuri Santhamma Center for Vitreo-Retina Diseases, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anand Vinekar
- Department of Pediatric Retina, Narayana Nethralaya Eye Institute, New Delhi, India
| | - Parijat Chandra
- Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Tapas Ranjan Padhi
- Vitreoretina and Uveitis Services, L V Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar, Odisha, India
| | - Sameera Nayak
- Vitreoretina and Uveitis Services, L V Prasad Eye Institute, Kode Venkatadri Chowdhary Campus, Vijaywada, Andhra Pradesh, India
| | - Sushma Jayanna
- Srimati Kanuri Santhamma Center for Vitreo-Retina Diseases, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Bhavik Panchal
- Vitreoretina and Uveitis Services, L V Prasad Eye Institute, Granthi Mallikarjun Rao Varalaksmi Campus, Visakhapatnam, Andhra Pradesh, India
| | - Subhadra Jalali
- Srimati Kanuri Santhamma Center for Vitreo-Retina Diseases, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Taraprasad Das
- Srimati Kanuri Santhamma Center for Vitreo-Retina Diseases, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Russo C, Strianese D, Perrotta M, Iuliano A, Bernardo R, Romeo V, Ugga L, Brunetti L, Tranfa F, Elefante A. Multi-parametric magnetic resonance imaging characterization of orbital lesions: a triple blind study. Semin Ophthalmol 2020; 35:95-102. [PMID: 32298217 DOI: 10.1080/08820538.2020.1742358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Multi-parametric MRI used for preoperative assessment of orbital lesions does not routinely include DCE-MRI, since its accuracy in differential diagnosis of orbital mass is still under debate. Aim of this study is to characterize orbital lesions by multi-parametric MRI, analysing the incremental predictive value of DCE-MRI in differential diagnosis of orbital lesions.Methods: In this prospective triple-blind study, 43 consecutive patients with unilateral orbital lesion underwent conventional multimodal MRI and DCE-MRI before biopsy in a tertiary referral centre. Pre-operative MRI examination including conventional unenhanced MRI protocol, DWI with ADC maps, static CE 3D-T1 w and dynamic CE T1 w sequences, was performed within 1 week from surgery (anterior/lateral orbitotomy depending on location of the lesion, to carry out incisional/excisional biopsy).Results: Comparison between conventional T1 w/T2 w, DWI, CE 3D-T1 w and DCE-MRI groups showed a statistically significant difference in scores distribution (p < .001). Statistically significant difference was found between conventional T1 w/T2 w and DWI (p < .005), as well as between DWI and CE 3D-T1 w (p < .001). Conversely, no significant difference was found between CE 3D-T1 w and DCE (p < .005).Conclusions and Relevance: This study confirmed the positive effect of DWI and CE 3D-T1 w on orbital lesions diagnosis when added to conventional T1 w/T2 w sequences, whereas no substantial impact on diagnostic performance was observed with the further addition of DCE-MRI. DCE does not strongly influence diagnostic performance and inter-rater agreement in characterizing orbital lesions; therefore, it should be recommended in selected patients whose assessment of flow dynamics is particularly useful for management.Abbreviations: US = ultrasonography; MRI = magnetic resonance imaging; CT = computed tomography; STIR = Short-TI Inversion Recovery; DWI = diffusion weighted imaging; DCE-MRI = dynamic contrast-enhanced MRI; SE = Spin-Echo; TSE = Turbo Spin-Echo; THRIVE = T1-weighted high resolution Isotropic Volume Examination (dynamic contrast-enhanced ultrafast spoiled gradient echo); ROI = regions of interest; IRR = inter-rater reliability; TIC = time-intensity curve.
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Affiliation(s)
- Camilla Russo
- Department of Advanced Biomedical Sciences, Università Degli Studi Di Napoli "Federico II", Napoli, Italy
| | - Diego Strianese
- Orbital Unit, CME Department, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Neuroscience, Odontostomatological and Reproductive Sciences, Università Degli Studi Di Napoli "Federico II", Napoli, Italy
| | - Marianna Perrotta
- Department of Advanced Biomedical Sciences, Università Degli Studi Di Napoli "Federico II", Napoli, Italy
| | - Adriana Iuliano
- Department of Neuroscience, Odontostomatological and Reproductive Sciences, Università Degli Studi Di Napoli "Federico II", Napoli, Italy
| | - Roberta Bernardo
- Department of Neuroscience, Odontostomatological and Reproductive Sciences, Università Degli Studi Di Napoli "Federico II", Napoli, Italy
| | - Valeria Romeo
- Department of Advanced Biomedical Sciences, Università Degli Studi Di Napoli "Federico II", Napoli, Italy
| | - Lorenzo Ugga
- Department of Advanced Biomedical Sciences, Università Degli Studi Di Napoli "Federico II", Napoli, Italy
| | - Lisa Brunetti
- Neuroradiology Unit, Università Vita-Salute San Raffaele, Milano, Italy
| | - Fausto Tranfa
- Department of Neuroscience, Odontostomatological and Reproductive Sciences, Università Degli Studi Di Napoli "Federico II", Napoli, Italy
| | - Andrea Elefante
- Department of Advanced Biomedical Sciences, Università Degli Studi Di Napoli "Federico II", Napoli, Italy
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De La Hoz Polo M, Torramilans Lluís A, Pozuelo Segura O, Anguera Bosque A, Esmerado Appiani C, Caminal Mitjana JM. Ocular ultrasonography focused on the posterior eye segment: what radiologists should know. Insights Imaging 2016; 7:351-64. [PMID: 26910565 PMCID: PMC4877345 DOI: 10.1007/s13244-016-0471-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/23/2016] [Accepted: 01/26/2016] [Indexed: 11/29/2022] Open
Abstract
Abstract Ocular B-mode ultrasonography (US) is an important adjuvant for the clinical assessment of a variety of ocular diseases. When ophthalmoscopy is not possible, mainly due to opacification of the transparent media (e.g., mature cataract or vitreous haemorrhage), US can guide the ophthalmologist in diagnosing disease and choosing treatment. The superficial location and cystic structure of the eye make US ideal for imaging of the eye. Moreover, dynamic study helps distinguish between various conditions that would otherwise be difficult to differentiate in some clinical setting, such as vitreous, retinal, and choroidal detachment. US is also good technique for detecting other pathologic conditions such as lens dislocation, vitreous haemorrhage, asteroid hyalosis, optic disc drusen, and tumors (e.g., choroidal melanoma, metastases, hemangioma). An understanding of the basic anatomy of the eye, the US technique, and common entities that affect the ocular globe will allow radiologists to offer this valuable imaging modality to patients and referring clinicians. This article focuses on the US anatomy and pathologic conditions that affect the posterior ocular segment. Teaching points • US is specially indicated when ocular fundus cannot be assessed on ophthalmoscopy. • Multipurpose equipment with high-frequency transducers is optimal for imaging the eye. • Ultrasound can reliably depict ocular anatomy and pathology as detachments and tumours. • Dynamic examination is vital for distinguishing certain pathologic conditions as detachments. Electronic supplementary material The online version of this article (doi:10.1007/s13244-016-0471-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marcela De La Hoz Polo
- Radiology Department, Hospital Sant Pau i Santa Tecla, Rambla Vella 14, 43003, Tarragona, Spain. .,Hospital El Vendrell, Carretera de Barcelona, s/n, 43700, El Vendrell, Spain.
| | | | - Oscar Pozuelo Segura
- Radiology Department, Hospital Sant Pau i Santa Tecla, Rambla Vella 14, 43003, Tarragona, Spain.,Hospital El Vendrell, Carretera de Barcelona, s/n, 43700, El Vendrell, Spain
| | - Albert Anguera Bosque
- Radiology Department, Hospital Sant Pau i Santa Tecla, Rambla Vella 14, 43003, Tarragona, Spain.,Hospital El Vendrell, Carretera de Barcelona, s/n, 43700, El Vendrell, Spain
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Ocular ultrasound as an easy applicable tool for detection of Terson's syndrome after aneurysmal subarachnoid hemorrhage. PLoS One 2014; 9:e114907. [PMID: 25502695 PMCID: PMC4263478 DOI: 10.1371/journal.pone.0114907] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 11/14/2014] [Indexed: 11/26/2022] Open
Abstract
Introduction Intraocular hemorrhage in patients suffering from aneurysmal subarachnoid hemorrhage is known as Terson's syndrome and is an underestimated but common pathology. We therefore designed a prospective single-blinded study to evaluate the validity of ocular ultrasound compared to the gold standard indirect funduscopy in the diagnosis of Terson's syndrome. Material and Methods Fifty-two patients (104 eyes in total) suffering from aneurysmal subarachnoid hemorrhage were enrolled in this study. Two investigators independently performed a single-blinded ocular ultrasound using a standard intensive care ultrasound system to detect an intraocular hemorrhage. Indirect funduscopy following iatrogenic mydriasis served as the gold standard for confirmation or exclusion of an intraocular hemorrhage. Statistical analyses were performed to evaluate the sensitivity and specificity, positive and negative predictive values of the method as well as the learning curve of ocular ultrasound. Results Indirect funduscopy detected Terson's syndrome in 11 of 52 (21.2%) respectively in 21 of 104 (20.2%) eyes in patients suffering from subarachnoid hemorrhage. Sensitivity and specificity increased with the number of ocular ultrasound examinations for both investigators, reaching 81.8% and 100% respectively. Positive and negative predictive values were different for both investigators (63.6% vs. 100% positive and 100% vs. 95.7% negative) but were both correlated to the amount of intraocular hemorrhage. A low Glasgow Coma scale (p = 0.015) and high Hunt & Hess grade (p = 0.003) was associated with a higher rate of Terson's syndrome. Conclusions Ocular ultrasound using standard ultrasound equipment has been confirmed as a reliable, easy-to-handle bedside screening tool for detecting Terson's syndrome. Nevertheless funduscopy remains the gold standard to detect Terson's syndrome.
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Ye Y, Wu Z, Lewis NA, Fan Q, Haacke EM. Retrobulbar magnetic resonance angiography using binomial off-resonant rectangular (BORR) pulse. Magn Reson Med 2014; 74:1050-6. [PMID: 25311332 DOI: 10.1002/mrm.25498] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 09/23/2014] [Accepted: 09/26/2014] [Indexed: 12/18/2022]
Abstract
PURPOSE Applying a newly developed binomial off-resonant rectangular (BORR) pulse method for high resolution three-dimensional MR angiography (MRA) on retrobulbar ocular vessels, which has not been possible with routine MRA due to background fatty tissues. METHODS BORR pulse was implemented in a gradient echo sequence by replacing the original excitation pulse, and were optimized for robust orbital fat suppression. Several other MRA methods, with or without fat suppression, were also compared, including time-of-flight, contrast enhanced MRA, and hybrid of opposite-contrast MRA. Nine healthy subjects participated with written informed consents. To reduce eye motion, the subjects were instructed to casually stare at a projected cross during each MRA scan. Major vessels were evaluated by three independent radiologists using a 4-point scale. RESULTS The BORR method yielded the best MRA results for retrobulbar vessels without contrast enhancement, significantly superior than other MRA methods. BORR results had significantly higher visibility scores than all other methods for small vessels. CONCLUSION We have successfully revealed orbital vessels in retrobulbar space for the first time using MRA, by using the BORR pulse method. With a clear depiction of the vasculature without the need for contrast enhancement, our method has the potential to provide important diagnostic information for ocular vascular diseases.
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Affiliation(s)
- Yongquan Ye
- MR Research Facility, Department of Radiology, Wayne State University, Detroit, Michigan, USA
| | - Zhen Wu
- Department of Radiology, Wayne State University Detroit, Michigan, USA
| | - Nicholas A Lewis
- Department of Radiology, Wayne State University Detroit, Michigan, USA
| | - Qingxia Fan
- Eye clinical and vision research division, He Eye Hospital, Shenyang, Liaoning, China
| | - E Mark Haacke
- MR Research Facility, Department of Radiology, Wayne State University, Detroit, Michigan, USA
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Sánchez Torres L, Roman Soler A, Duran Feliubadaló C. Propuesta de protocolo para la ecografía ocular. IMAGEN DIAGNOSTICA 2014. [DOI: 10.1016/j.imadi.2014.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Orlandi D, Sconfienza LM, Lacelli F, Bertolotto M, Sola S, Mauri G, Savarino E, Serafini G. Ultrasound-guided core-needle biopsy of extra-ocular orbital lesions. Eur Radiol 2013; 23:1919-24. [DOI: 10.1007/s00330-013-2776-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 12/15/2012] [Accepted: 12/19/2012] [Indexed: 12/26/2022]
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Spierer O, Neudorfer M, Leibovitch I, Stolovitch C, Kessler A. Colour Doppler ultrasound imaging findings in paediatric periocular and orbital haemangiomas. Acta Ophthalmol 2012; 90:727-32. [PMID: 21457487 DOI: 10.1111/j.1755-3768.2011.02155.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the combined grey-scale ultrasonography (US) and colour Doppler imaging (CDI) as the first and primary imaging modalities in diagnosing paediatric orbital haemangiomas. METHODS The charts of 20 consecutive children with a periorbital mass echographically diagnosed as a haemangioma between January 2004 and June 2009 in the Tel-Aviv Sourasky Medical Center were reviewed. Data on demographic details, clinical findings, US and CDI characteristics, treatment and outcome were retrieved. RESULTS Twelve (60%) haemangiomas were located on the upper eyelid, five in the lower eyelid (25%) and three in the medial cantus (15%). The tumour resolved completely in 10 children (50%) and in 10 children (50%) partial resolution was documented. Seven (35%) patients underwent treatment (intralesional or oral steroids or propranolol). Grey-scale US depicted a solid-tissue mass with low internal echogenicity. Mean haemangioma volume was 1.33 cm(3) . Colour Doppler imaging demonstrated intralesional flow with a mean peak systolic velocity of 15.2 cm per second and a mean resistance index of 0.51. All US and CDI examinations were carried out on alert children and no sedation or general anaesthesia was needed. During mean follow-up time of 23 months, no child required any additional imaging or diagnostic procedures to confirm the diagnosis. CONCLUSION Combined US and CDI are suggested as the first imaging modalities in cases with a suspected diagnosis of periocular and orbital capillary haemangioma.
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Affiliation(s)
- Oriel Spierer
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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Galhotra R, Gupta K, Kaur S, Singh P. Bilateral persistent hyperplastic primary vitreous: A rare entity. Oman J Ophthalmol 2012; 5:58-60. [PMID: 22557881 PMCID: PMC3339679 DOI: 10.4103/0974-620x.94780] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ritu Galhotra
- Department of Radiodiagnosis, Dyanand Medical College and Hospital, Ludhiana, Punjab, India
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Lorente-Ramos RM, Armán JA, Muñoz-Hernández A, Gómez JMG, de la Torre SB. US of the Eye Made Easy: A Comprehensive How-to Review with Ophthalmoscopic Correlation. Radiographics 2012; 32:E175-200. [DOI: 10.1148/rg.325115105] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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US and MRI of pediatric ocular masses with histopathological correlation. Pediatr Radiol 2012; 42:738-49. [PMID: 22466750 PMCID: PMC3530407 DOI: 10.1007/s00247-012-2374-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 02/15/2012] [Accepted: 02/16/2012] [Indexed: 10/28/2022]
Abstract
We review our experience with unusual ocular pathologies, some mimicking retinoblastoma, that were referred to our institution during the past two decades. After presenting the imaging anatomy of the normal eye, we discuss pertinent clinical and pathological features, and illustrate the US and MRI appearance of retinoblastoma, medulloepithelioma, uveal melanoma, persistent fetal vasculature, Coats disease, corneal dermoid, retinal dysplasia and toxocara granuloma. Features useful in discriminating among these entities are emphasized.
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Silva CT, Brockley CR, Crum A, Mandelstam SA. Pediatric Ocular Sonography. Semin Ultrasound CT MR 2011; 32:14-27. [DOI: 10.1053/j.sult.2010.09.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chung EM, Murphey MD, Specht CS, Cube R, Smirniotopoulos J. From the Archives of the AFIP Pediatric Orbit Tumors and Tumorlike Lesions: Osseous Lesions of the Orbit. Radiographics 2008; 28:1193-214. [DOI: 10.1148/rg.284085013] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chung EM, Smirniotopoulos JG, Specht CS, Schroeder JW, Cube R. Pediatric Orbit Tumors and Tumorlike Lesions: Nonosseous Lesions of the Extraocular Orbit. Radiographics 2007; 27:1777-99. [DOI: 10.1148/rg.276075138] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Chung EM, Specht CS, Schroeder JW. From the archives of the AFIP: Pediatric orbit tumors and tumorlike lesions: neuroepithelial lesions of the ocular globe and optic nerve. Radiographics 2007; 27:1159-86. [PMID: 17620473 DOI: 10.1148/rg.274075014] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Tumors and tumorlike lesions of the globe and optic nerve in children represent a different histologic spectrum than in adults; the imaging appearances of these lesions reflect their pathologic features. Retinoblastoma is a tumor of infancy and the most common intraocular tumor in children. There are heritable and nonheritable forms. The most common clinical finding is leukocoria. The differential diagnoses of this sign include several nonneoplastic lesions: Persistent hyperplastic primary vitreous is a congenital persistence of an embryonic structure causing a retrolental mass. The primitive vasculature may produce a septum in the posterior chamber. Coats disease is a vascular malformation of the retina that produces a lipoproteinaceous subretinal exudate. The vascular malformation enhances with intravenous contrast material, and the fat-containing subretinal exudate does not. Larval endophthalmitis is a granulomatous reaction to the dead or dying larvae of Toxocara canis or T. cati. The most important feature that allows differentiation of retinoblastoma from these so-called pseudoretinoblastomas is the presence of calcification in the former. Medulloepithelioma has two histologic forms; the teratoid type may contain calcifications, but it usually arises anteriorly from the ciliary body rather than posteriorly from the retina. Optic nerve glioma is the most common tumor of the optic nerve in children and is frequently associated with neurofibromatosis type 1. These gliomas are usually pilocytic astrocytomas and cause fusiform enlargement of the nerve.
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Affiliation(s)
- Ellen M Chung
- Department of Radiologic Pathology, Armed Forces Institute of Pathology, Alaska and Fern streets NW, Washington, DC 20306-6000, USA.
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Neudorfer M, Leibovitch I, Stolovitch C, Dray JP, Hermush V, Nagar H, Kessler A. Intraorbital and periorbital tumors in children--value of ultrasound and color Doppler imaging in the differential diagnosis. Am J Ophthalmol 2004; 137:1065-72. [PMID: 15183791 DOI: 10.1016/j.ajo.2004.01.050] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2004] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate the role of ultrasonography (US) and color Doppler imaging (CDI) in the diagnosis of orbital tumors in children. DESIGN Retrospective nonrandomized interventional case series. METHODS This study included 42 children with intraorbital and periorbital tumors who were evaluated in our clinic. All children underwent a complete clinical evaluation as well as orbital US and CDI. The children then underwent operation or were followed up, based on the clinical diagnosis and the findings on the imaging modalities. RESULTS The mean age of the patients at diagnosis was 22.5 months (range 2 weeks-14 years old). Eighteen patients (12 female and 6 male) were diagnosed with hemangioma based on the findings in US and CDI; 16 patients (9 female and 7 male) were diagnosed with dermoid, 5 patients (4 female and 1 male) with lymphangioma, 2 patients with rhabdomyosarcoma, and 1 patient with a subperiostal abscess. Twenty-two patients underwent operation, and the diagnosis was confirmed on pathology. Twenty patients did not undergo operation and continued to be followed up in the clinic (mean follow-up period 38.2 months). The disease course in all patients who did not undergo operation was consistent with the working diagnosis. CONCLUSION Both US and CDI are useful modalities in the diagnosis of intraorbital and periorbital tumors in the pediatric age group.
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Affiliation(s)
- Meira Neudorfer
- Department of Ophthalmology, Tel-Aviv Medical Center, Tel-Aviv, Israel.
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Casos en imagen 3.—Vítreo primario persistente e hiperplásico. RADIOLOGIA 2004. [DOI: 10.1016/s0033-8338(04)78000-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gorospe L, Royo A, Berrocal T, García-Raya P, Moreno P, Abelairas J. Imaging of orbital disorders in pediatric patients. Eur Radiol 2003; 13:2012-26. [PMID: 12942303 DOI: 10.1007/s00330-002-1738-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2002] [Revised: 07/24/2002] [Accepted: 10/01/2002] [Indexed: 10/26/2022]
Abstract
The spectrum of orbital lesions occurring in childhood is wide, including a variety of both benign and malignant disorders. Although physical examination and fundoscopy may aid in establishing the diagnosis of retro-ocular lesions, imaging remains a critical step in the evaluation of the pediatric orbit. Ultrasonography, CT, and MR imaging are the primary modalities for the evaluation of the diseased orbit, and careful observation of the characteristic radiological features usually leads to correct diagnosis; however, some of the lesions look very similar and are difficult to differentiate from each other. The purpose of this article is to review the common and unusual entities that may involve the pediatric orbit, to describe the radiological features, and to evaluate the efficacy of US, CT, and MRI in the diagnosis and management of these conditions.
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Affiliation(s)
- Luis Gorospe
- Department of Radiology, La Paz University Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain.
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Abstract
Vascular lesions represent an important subgroup of orbital abnormalities; however, there is much controversy regarding their pathophysiology and nomenclature. Attempts at resolution of some of the issues have resulted in changes of names of some of the lesions (e.g., lymphangioma to venolymphatic malformation). Imaging plays an important role in delineation and characterization of these lesions. A radiologist informed about the pathophysiology and attentive to the internal architecture of the lesions shown on images, particularly MR images, often can predict the histologic diagnosis. Imaging information helps clarify some of the controversies surrounding these lesions.
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Affiliation(s)
- L T Bilaniuk
- Department of Radiology, Children's Hospital of Philadelphia, Pennsylvania, USA
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Boroffka SA, Verbruggen AM, Boevé MH, Stades FC. Ultrasonographic diagnosis of persistent hyperplastic tunica vasculosa lentis/persistent hyperplastic primary vitreous in two dogs. Vet Radiol Ultrasound 1998; 39:440-4. [PMID: 9771597 DOI: 10.1111/j.1740-8261.1998.tb01632.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Ultrasonography was performed on a Basset hound and a Doberman clinically suspected of persistent hyperplastic tunica vasculosa lentis/persistent hyperplastic primary vitreous. In both dogs, hyperechoic lenses with a triangular-shaped echodense structure retrolentally were visible, and a very thin hyperechoic strand was seen penetrating the anechoic vitreous from this retrolental tissue to the area of the optic nerve. Using color Doppler imaging, blood flow was evident in parts of the retina in both dogs. With power Doppler imaging there was blood flow in the lens and hyperechoic strand of the Basset hound on the first examination; whereas, on re-examination 5 months later, this was not found. Other abnormalities, such as retinal detachment, endophthalmitis, vitreous hemorrhage, microphthalmia, and posterior neoplasia could be excluded.
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Affiliation(s)
- S A Boroffka
- Department of Radiology, Faculty of Veterinary Medicine, Utrecht University, The Netherlands
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