Usefulness of colour Doppler flow imaging in the management of lacrimal gland lesions.
OBJECTIVE
To assess the role of colour Doppler flow imaging (CDFI) in the diagnosis and management of lacrimal fossa lesions.


METHODS
Institutional ethical committee approval was obtained. Fifty-one patients with 62 lacrimal fossa lesions were retrospectively included from 2003-2015. All patients underwent conventional ultrasonography and CDFI, with a qualitative and quantitative analysis of the vascularization. All patients had lacrimal gland surgery. Definitive diagnosis was based on pathological examination.


RESULTS
The study included 47 non-epithelial lesions (NEL) and 15 epithelial lesions (EL), with 24 (39 %) malignant lesions and 38 (61 %) benign lesions. NEL were significantly more likely to present with septa (p < 0.001), hypoechogenicity (p < 0.001), high vascular intensity (p < 0.001), both central and peripheral vascularization (p < 0.001), tree-shape vascularization (p < 0.05) and a low resistance index (RI) (p < 0.0001). EL were significantly more likely to present with the presence of cysts (p < 0.001), and a higher RI. Receiver operating characteristic curves identified a RI value of 0.72 as the best cut-off to differentiate NEL from EL, with a sensitivity and specificity of 100 %.


CONCLUSIONS
CDFI is a valuable tool in the differential diagnosis of lacrimal fossa lesions. Resistance index measurement enables substantial distinction between EL and NEL, thus providing crucial data for surgical management.


CONCLUSIONS
• CDFI is a valuable tool in lacrimal fossa lesions. • Resistance Index measurement enables substantial distinction between epithelial and non-epithelial lesions. • Management of patients becomes more appropriate.
Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France. alecler@fo-rothschild.fr.
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Lecler
Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France.
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Boucenna
Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France.
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Lafitte
Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France.
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Koskas
Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France.
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Nau
Department of Orbito Palpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
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Jacomet
Department of Orbito Palpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
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Galatoire
Department of Orbito Palpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
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Morax
Department of Pathology (M.P.), Necker-Enfants Malades Hospital APHP, Paris, France.
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Putterman
Department of Orbito Palpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
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Mann
Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France.
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Héran
Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France.
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Sadik
Clinical Research Unit, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
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Picard
Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75019, Paris, France.
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Bergès
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003607:Dacryocystitis / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005134:Eye Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000098:blood supply / Q000000981:diagnostic imaging*; D007766:Lacrimal Apparatus Diseases / Q000000981:diagnostic imaging*; D017078:Laser-Doppler Flowmetry; D000072281:Lymphadenopathy / Q000000981:diagnostic imaging; D008223:Lymphoma / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D055815:Young Adult
Colour Doppler ultrasound; Diagnostic imaging; Lacrimal apparatus; Neoplasms; Orbit