CT arteriography for orbital tumors: diagnostic and surgical value.
The aim of this study is to investigate the efficacy of dynamic computed tomography (CT) during selective angiography (CT-arteriography) of orbital tumors in the evaluation of intratumoral vascular anatomy, feeding artery territory, and histological diagnosis. Among 35 consecutive cases with various orbital lesions, those cases showing tumor staining or pooling of the contrast medium on digital subtraction angiography (DSA) were evaluated by CT-arteriography (n = 14). The information obtained by CT-arteriography was compared with that provided by enhanced MRI (n = 31) and dynamic MRI (n = 21), in which the contrast medium was injected intravenously. In addition to the visualization of fine vascular anatomy, CT-arteriography emphasized areas of nodular enhancement and non-enhancing cystic/necrotic components as well as the intratumoral feeding arteries. Patterns of CT-arteriography were categorized into three subgroups: homogeneous enhancement (benign lymphoid lesion), partial enhancement (schwannomas and carcinomas), and patchy multinodular enhancement (specific for cavernous angiomas). In addition, CT-arteriography with selective arterial catheterization clearly delineated the feeding artery territories. CT-arteriography, with a minimal dose of contrast medium, can offer significant advantages over intravenously injected dynamic neuroimaging, and provides additional valuable preoperative information about the orbital tumor under investigation.
Department of Neurosurgery, Division of Neuroscience, Graudate School of Medical Science, Kanazawa University, Kanazawa, Japan. hasegawa@ns.m.kanazawa-u.ac.jp
Mitsuhiro
M
Hasegawa
Hironori
H
Fujisawa
Yutaka
Y
Hayashi
Junkoh
J
Yamashita
Masayuki
M
Suzuki
Osamu
O
Matsui
D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods / Q000639:trends; D001932:Brain Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D002277:Carcinoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media / Q000592:standards; D003937:Diagnosis, Differential; D005260:Female; D006392:Hemangioma, Cavernous / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007765:Lacrimal Apparatus / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging* / Q000473:pathology*; D019574:Optic Nerve Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D009915:Orbit / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D009918:Orbital Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000473:pathology; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000639:trends*
D003287:Contrast Media