Abstract
Purpose :
Vascular lesions of the orbit present an investigation and surgical challenge. This study is about the role of Time-resolved angiography with stochastic trajectories (TWIST) magnetic resonance angiography (MRA), in the evaluation and management of distensible vascular malformations of orbit.
Methods :
We prospectively studied the role of TWIST MRA (on Siemens Aera 1.5T) a noninvasive, non-radiation, dynamic imaging modality for the evaluation of distensible vascular malformations.
Results :
Sixteen patients with distensible vascular malformations of orbit were evaluated using TWIST MRA. These included 7 (43.75%) with cavernous hemangioma, 7 (43.75%) with venous varix and 2 (12.50%) with mixed malformations after imaging. All (100%) were low-flow vascular malformations. Lesions were excised in 8 for symptoms of pain, cosmesis and swelling. Histopathology revealed cavernous hemangioma in 6, lymphangioma and venous varix in 1each, which are all low-flow lesions. In terms of flow pattern based on the hemodynamic study, there was 100% correlation between preoperative and postoperative diagnosis. However, specific tissue diagnosis of orbital lesions correlated with only 50% of imaging diagnosis.
Conclusions :
In a clinically distensible vascular lesion of the orbit, TWIST MRA helps to distinguish the hemodynamic flow pattern thereby avoiding radiation. As a result of which a surgeon can plan surgical excision with the local use of embolic agents.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.