Top

European Radiology

Published in:

Open Access 01-09-2010 | Head and Neck

Evaluation of MR imaging findings differentiating cavernous haemangiomas from schwannomas in the orbit

Authors: Junfang Xian, Zhengyu Zhang, Zhenchang Wang, Jing Li, Bentao Yang, Qinghua Chen, Qinglin Chang, Liyan He

Published in: European Radiology | Issue 9/2010

Abstract

Objective

It is important to distinguish between orbital cavernous haemangioma and schwannoma because the treatments of choice for the two tumours are different. The aim was to evaluate MR imaging findings distinguishing the two tumours.

Methods

Magnetic resonance imaging including T1- and T2-weighted imaging and contrast-enhanced MR imaging was performed in 43 patients with cavernous haemangiomas and 16 patients with schwannomas confirmed by pathology. Location, configuration, margins, signal intensity, homogeneity and enhancement pattern of the tumour were retrospectively evaluated.

Results

There was a significant difference between cavernous haemangiomas and schwannomas regarding the location, configuration and margins of the mass, signal intensity and homogeneity on T1- and T2-weighted imaging, the spread pattern of contrast enhancement, the enhancement pattern and the type of time–intensity curve (P < 0.05). Markedly homogeneous hyperintensity signal on T2-weighted imaging and the spread pattern of the contrast enhancement favoured cavernous haemangioma rather than schwannoma (P < 0.01).

Conclusion

Cavernous haemangiomas and schwannomas have different MR imaging features that could be helpful in the differentiation between the tumours. The spread pattern of the contrast enhancement on dynamic contrast-enhanced MR imaging is the most reliable finding distinguishing cavernous haemangiomas from schwannomas.

Shields JA, Bakewell B, Augsburger JJ, Flanagan JC (1984) Classification and incidence of space-occupying lesions of the orbit. A survey of 645 biopsies. Arch Ophthalmol 102:1606–1611

Moss HM (1962) Expanding lesions of the orbit. A clinical study of 230 consecutive cases. Am J Ophthalmol 54:761–770

Shields JA, Shields CL, Scartozzi R (2004) Survey of 1264 patients with orbital tumors and simulating lesions: the 2002 Montgomery Lecture, part 1. Ophthalmology 111:997–1008CrossRefPubMed

Ruchman MC, Flanagan J (1983) Cavernous hemangiomas of the orbit. Ophthalmology 90:1328–1336PubMed

Bilaniuk LT (1999) Orbital vascular lesions. Role of imaging. Radiol Clin North Am 37:169–183

Gunduz K, Shields CL, Gunalp I, Erden E, Shields JA (2003) Orbital schwannoma: correlation of magnetic resonance imaging and pathology findings. Graefes Arch Clin Exp Ophthalmol 241:593–597CrossRefPubMed

Ansari SA, Mafee MF (2005) Orbital cavernous hemangioma: role of imaging. Neuroimaging Clin North Am 15:137–158CrossRef

Kapur R, Mafee MF, Lamba R, Edward DP (2005) Orbital schwannoma and neurofibroma: role of imaging. Neuroimaging Clin North Am 15:159–174CrossRef

Scheuerle AF, Steiner HH, Kolling G, Kunze S, Aschoff A (2004) Treatment and long-term outcome of patients with orbital cavernomas. Am J Ophthalmol 138:237–244CrossRefPubMed

10.

Xian J, Zhang Z, Wang Z, Li J, Yang B, Man F et al (2010) Value of MR imaging in the differentiation of benign and malignant orbital tumors in adults. Euro Radiol. doi:10.1007/S00330-009-1711-0

11.

Thorn-Kany M, Delisle MB, Lacroix F, Lagarrigue J, Manelfe C (1999) Cavernous hemangiomas of the orbit: MR imaging. J Neuroradiol 26:79–86PubMed

12.

Tanaka A, Mihara F, Yoshiura T, Togao O, Kuwabara Y, Natori Y et al (2004) Differentiation of cavernous hemangioma from schwannoma of the orbit: a dynamic MRI study. AJR Am J Roentgenol 183:1799–1804PubMed

13.

Wilms G, Raat H, Dom R, Carlo T, Philippe D, Godelieve D et al (1995) Orbital cavernous hemangioma: findings on sequential Gd-enhanced MRI. J Comput Assist Tomogr 19:548–551CrossRefPubMed

14.

Ohtsuka K, Hashimoto M, Akiba H (1997) Serial dynamic magnetic resonance imaging of orbital cavernous hemangioma. Am J Ophthalmol 123:396–398PubMed

15.

Rootman J (2003) Vascular malformations of the orbit: hemodynamic concepts. Orbit 22:103–120CrossRefPubMed

16.

Mafee MF, Putterman A, Valvassori GE, Campos M, Capek V (1987) Orbital space-occupying lesions: role of computed tomography and magnetic resonance imaging. An analysis of 145 cases. Radiol Clin North Am 25:529–559

17.

Bilaniuk LT, Rapoport RJ (1994) Magnetic resonance imaging of the orbit. Top Magn Reson Imaging 6:167–181CrossRefPubMed

18.

Xian J, Xu X, Wang Z, Yang B, Li B, Man F et al (2009) Magnetic resonance imaging findings of the uveal schwannoma. AJNR Am J Neuroradiol 30:769–773CrossRefPubMed

19.

Lam DSC, Ng JSK, To KF, Abdulah V, Liew CT, Tso MOM (1997) Cystic schwannoma of the orbit. Eye 11:798–800PubMed

20.

Wilms G (2009) Orbital cavernous hemangiomas. AJNR Am J Neuroradiol 30:E7CrossRefPubMed

21.

van Rijswijk CS, Geirnaerdt MJ, Hogendoorn PC, Taminiau AH, van Coevorden F, Zwinderman AH (2004) Soft-tissue tumors: value of static and dynamic gadopentetate dimeglumine-enhanced MR imaging in prediction of malignancy. Radiology 233:493–502CrossRefPubMed

22.

Schnall MD, Blume J, Bluemke DA, DeBruhl N, Harms S, Heywang Kobrunner SH et al (2006) Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology 238:42–53CrossRefPubMed

Title: Evaluation of MR imaging findings differentiating cavernous haemangiomas from schwannomas in the orbit
Authors: Junfang Xian
Zhengyu Zhang
Zhenchang Wang
Jing Li
Bentao Yang
Qinghua Chen
Qinglin Chang
Liyan He
Publication date: 01-09-2010
Publisher: Springer-Verlag
Published in: European Radiology / Issue 9/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-010-1774-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation of MR imaging findings differentiating cavernous haemangiomas from schwannomas in the orbit

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 9/2010

Comprehensive imaging of residual/recurrent nasopharyngeal carcinoma using whole-body MRI at 3 T compared with FDG-PET-CT

Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates

Non-invasive tracking of human haemopoietic CD34+ stem cells in vivo in immunodeficient mice by using magnetic resonance imaging

Detection of relevant colonic neoplasms with PET/CT: promising accuracy with minimal CT dose and a standardised PET cut-off

Coronary artery stent imaging with 128-slice dual-source CT using high-pitch spiral acquisition in a cardiac phantom: comparison with the sequential and low-pitch spiral mode

Multi-detector CT urography: effect of oral hydration and contrast medium volume on renal parenchymal enhancement and urinary tract opacification—a quantitative and qualitative analysis