title: High-spatial-resolution isotropic three-dimensional fast-recovery fast spin-echo magnetic resonance dacryocystography combined with topical administration of sterile saline solution.
abstract: OBJECTIVE
  This study aims to investigate the clinical performance of three-dimensional (3D) fast-recovery fast spin-echo (FRFSE) magnetic resonance dacryocystography (MRD) with topical administration of sterile saline solution for the assessment of the lacrimal drainage system (LDS).
  
  
  METHODS
  A total of 13 healthy volunteers underwent both 3D-FRFSE MRD and two-dimensional (2D)-impulse recovery (IR)-single-shot fast spin-echo (SSFSE) MRD after topical administration of sterile saline solution, and 31 patients affected by primary LDS outflow impairment or postsurgical recurrent epiphora underwent 3D-FRFSE MRD and conventional T1- and T2-weighted sequences. All patients underwent lacrimal endoscopy or surgery, which served as a standard of reference for confirming the MRD findings.
  
  
  RESULTS
  3D-FRFSE MRD detected more visualized superior and inferior canaliculi and nasolacrimal duct than 2D-IR-SSFSE MRD. Compared with 2D-IR-SSFSE MRD, 3D-FRFSE MRD showed more visualized segments per LDS, although the difference was not statistically significant. Significant improvements in the inferior canaliculus and nasolacrimal duct visibility grades were achieved using 3D-FRFSE MRD. 3D-FRFSE MRD had 100% sensitivity and 63.6% specificity for detecting LDS obstruction. In 51 out of the 62 LDSs that were assessed, a 90% agreement was noted between the findings of 3D-FRFSE MRD and lacrimal endoscopy in detecting the obstruction level.
  
  
  CONCLUSIONS
  3D-FRFSE MRD combined with topical administration of sterile saline solution is a simple and noninvasive method of obtaining detailed morphological and functional information on the LDS. Overall, 3D-FRFSE MRD could be used as a reliable diagnostic method in many patients with epiphora prior to surgery.
authors.affiliation: Department of Radiology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030, PR China. hbtjzj@yahoo.com.cn
authors.forename: Zhang
authors.initials: Z
authors.lastname: Jing
authors.forename: Chen
authors.initials: C
authors.lastname: Lang
authors.forename: Wang
authors.initials: W
authors.lastname: Qiu-Xia
authors.forename: Liu
authors.initials: L
authors.lastname: Rong
authors.forename: Luo
authors.initials: L
authors.lastname: Xin
authors.forename: Zhu
authors.initials: Z
authors.lastname: Wen-Zhen
authors.forename: Xia
authors.initials: X
authors.lastname: Li-Ming
authors.forename: Qi
authors.initials: Q
authors.lastname: Jian-Pin
authors.forename: Wang
authors.initials: W
authors.lastname: He
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000465:Algorithms; D016880:Anisotropy; D003287:Contrast Media / Q000008:administration & dosage; D017352:Echo-Planar Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007765:Lacrimal Apparatus / Q000473:pathology*; D007766:Lacrimal Apparatus Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012965:Sodium Chloride / Q000008:administration & dosage*; D013113:Spin Labels; D013242:Sterilization; D055815:Young Adult
chemical_list: D003287:Contrast Media; D013113:Spin Labels; D012965:Sodium Chloride
keywords: Epiphora; Lacrimal apparatus; Magnetic resonance imaging; Topical administration