Abstract
Purpose :
To evaluate the diagnostic value and treatment guidance of lacrimal magnetic resonance hydrography（LMRH）and lacrimal endoscopy examination in lacrimal duct obstruction.
Methods :
A retrospective analysis of clinical and imaging data of 59 patients with epiphora who had LMRH examination in Tongji Hospital. Multiplanar reconstruction (MPR) and maximum intensity projection (MIP) were used to process the three dimensions T2-weighted images (T2WI). The lacrimal irrigation results were used as gold standard, the sensitivity; specificity; accuracy of LMRH in diagnosis of lacrimal duct obstructive diseases and the consistency between the two methods were analyzed. 22 cases had lacrimal endoscopy examination in less than half month after MRD; the results of lacrimal endoscopy were compared with LMRH images.
Results :
According to the results of lacrimal irrigation, among 78 eyes of 59 patients, 2 eyes were diagnosed as lacrimal canalicular obstruction (2.6%), 8 eyes were diagnosed as nasolacrimal duct stenosis (10.3%), 24 eyes were diagnosed as nasolacrimal duct obstruction (30.8%), 44 eyes were diagnosed as nasolacrimal duct obstruction accompanied with chronic dacryocystitis (56.4%). The other 40 eyes were negative controls. LMRH had a high degree of consistency with lacrimal irrigation in diagnosis of lacrimal duct obstructive diseases, the value of Kappa was 0.963 (P = 0.026). The sensitivity of MRD in diagnosis of lacrimal duct obstructive diseases was 97.4%, the specificity was 100%, the accuracy was 98.3%, the positive predictive value was 100%, the negative predictive value was 95.2%. 22 eyes underwent lacrimal endoscopy examination; the endoscopic findings were consistent with LMRH diagnosis, the lesions in the lacrimal duct displayed more clearly and intuitively than the LMRH, while LMRH had has its unique advantages in showing the size of lacrimal sac, the mucosal thickness of lacrimal duct, large foreign bodies and lesions around the lacrimal duct.
Conclusions :
LMRH is a noninvasive, reliable method to examine the lacrimal duct obstruction, can better display the size of lacrimal sac, lacrimal mucosal thickness, and surrounding soft tissues of lacrimal duct, it is a good complementary method of lacrimal endoscopy, has guiding significance for individualized treatment in patients with lacrimal duct obstruction.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.