This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (2)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Ocular/ Adnexal Tumors  • Ocular Imaging  • Radiologic Imaging  • Magnetic Resonance Imaging  • PET/ SPECT Imaging  • Alert me on articles by topic  Social Bookmarking   What's this?

Ennio Polito, MD; Luca Burroni, MD; Patrizia Pichierri, MD; Antonio Loffredo, MD; Angelo G. Vattimo, MD

Arch Ophthalmol. 2005;123:1678-1683.

Objectives  To evaluate technetium Tc 99m (^99mTc) red blood cell scintigraphy as a diagnostic tool for orbital cavernous hemangioma and to differentiate between orbital masses on the basis of their vascularization.

Methods  We performed ^99mTc red blood cell scintigraphy on 23 patients (8 female and 15 male; mean age, 47 years) affected by an orbital mass previously revealed with computed tomography (CT) and magnetic resonance imaging (MRI) and suggesting cavernous hemangioma. In our diagnosis, we considered the orbital increase delayed uptake with the typical scintigraphic pattern known as perfusion blood pool mismatch. The patients underwent biopsy or surgical treatment with transconjunctival cryosurgical extraction when possible.

Results  Single-photon emission tomography (SPET) showed intense focal uptake in the orbit corresponding to radiologic findings in 11 patients who underwent surgical treatment and pathologic evaluation (9 cavernous hemangiomas, 1 hemangiopericytoma, and 1 lymphangioma). Clinical or histologic examination of the remaining 22 patients revealed the presence of 5 lymphoid pseudotumors, 2 lymphomas, 2 pleomorphic adenomas of the lacrimal gland, 1 astrocytoma, 1 ophthalmic vein thrombosis, and 1 orbital varix.

Conclusions  The confirmation of the preoperative diagnosis by ^99mTc red blood cell scintigraphy shows that this technique is a reliable tool for differentiating cavernous hemangiomas from other orbital masses (sensitivity, 100%; specificity, 86%) when ultrasound, CT, and MRI are not diagnostic. Unfortunately, ^99mTc red blood cell scintigraphy results were positive in 1 patient with hemangiopericytoma and 1 patient with lymphangioma, which showed increased uptake in the lesion on SPET images because of the vascular nature of these tumors. Therefore, in these cases, the SPET images have to be integrated with data regarding clinical preoperative evaluation and CT scans or MRI studies. On the basis of our study, a complete diagnostic picture, CT scans or MRI studies, and scintigraphic patterns can establish the preoperative diagnosis of vascular orbital tumors such as cavernous hemangioma, adult-type lymphangioma, and hemangiopericytoma.

Author Affiliations: Departments of Ophthalmology and Neurosurgery (Drs Polito, Pichierri, and Loffredo) and Nuclear Medicine (Drs Burroni and Vattimo), University of Siena, Siena, Italy.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Elegant Diagnosis
Robert Alan Goldberg
Arch Ophthalmol. 2005;123(12):1739-1740.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Elegant Diagnosis
Goldberg
Arch Ophthalmol 2005;123:1739-1740.
FULL TEXT