Documente Academic
Documente Profesional
Documente Cultură
Any information contained in this pdf file is automatically generated from digital material
submitted to EPOS by third parties in the form of scientific presentations. References
to any names, marks, products, or services of third parties or hypertext links to third-
party sites or information are provided solely as a convenience to you and do not in
any way constitute or imply ECR's endorsement, sponsorship or recommendation of the
third party, information, product or service. ECR is not responsible for the content of
these pages and does not make any representations regarding the content or accuracy
of material in this file.
As per copyright regulations, any unauthorised use of the material or parts thereof as
well as commercial reproduction or multiple distribution by any traditional or electronically
based reproduction/publication method ist strictly prohibited.
You agree to defend, indemnify, and hold ECR harmless from and against any and all
claims, damages, costs, and expenses, including attorneys' fees, arising from or related
to your use of these pages.
Please note: Links to movies, ppt slideshows and any other multimedia files are not
available in the pdf version of presentations.
www.myESR.org
Page 1 of 64
Learning objectives
• To illustrate the spectrum of vascular lesions that can involve the orbit.
• To discuss and emphasize the role of MR angiography.
Background
Multiple vascular lesions can affect the orbit including neoplasms, malformations and
shunts. These lesions can manifest with proptosis or diplopia. Imaging differentiation
isessential because the management and prognosis vary greatly. MR angiography
provides useful information in the preoperative evaluation of these lesions.
Fig.
Page 2 of 64
The spectrum of vascular lesions that can involve the orbit include hemangiomas,
cavernous malformations, orbital varices, venous lymphatic malformations,
hemangiopericytomas, hemangioblastomas, vascular metastases, etc. They constitute
the most common group of pathologic conditions of the orbit.
We have made a pictorial review showing the more significant cases and describe the
specific imaging features that can help us in their diagnosis
Fig.
Page 3 of 64
Fig.
Page 4 of 64
Fig.
Page 5 of 64
Fig.
ORBITAL VARICES: True orbital varices are congenital venous vascular malformations
that we must distinguish from secondary enlarged veins resulting from arteriovenous
shunts or venous thrombosis. The cardinal clinical feature of true varices is intermitent
proptosis, but occasionally they may cause orbital hemorrhage (spontaneous or
posttraumatic) manifesting as sudden proptosis. Orbital varices usually communicate
with the venous system, therefore an enlargement of these varicous veins results during
maneuvers that increase venous pressure (Valsalva maneuver or prone position)
Page 6 of 64
Fig.
Page 7 of 64
Fig.
Page 8 of 64
Fig.
Page 9 of 64
Fig.
Page 10 of 64
Fig.
Page 11 of 64
Fig.
Page 12 of 64
Fig.
Page 13 of 64
Fig.
Page 14 of 64
Fig.
Page 15 of 64
Fig.
Page 16 of 64
Fig.
Page 17 of 64
Fig.
B/ VENOUS-LYMPHATIC MALFORMATIONS:
Page 18 of 64
Fig.
Page 19 of 64
Fig.
Page 20 of 64
Fig.
Page 21 of 64
Fig.
C/ VASCULAR NEOPLASMS:
Page 22 of 64
Fig.
CAPILLARY HEMANGIOMAS: They are the most frequent orbital vascular tumors in
children.
Page 23 of 64
Fig.
Page 24 of 64
Fig.
Page 25 of 64
hemangiomas, but usually have infiltrative and irregular margins with adjacent bone
erosion.
Fig.
Page 26 of 64
Fig.
Page 27 of 64
Fig.
Page 28 of 64
Fig.
VASCULAR METASTASES: The most common origin tumors are breast and lung in
adults and retinoblastoma and neuroblastoma in chidhood, but typical hypervascular
metastases are secondary to thyroid, renal and melanoma neoplasms
Page 29 of 64
Fig.
Page 30 of 64
Fig.
Page 31 of 64
Fig.
Page 32 of 64
Fig.
Page 33 of 64
Fig.
Page 34 of 64
Fig.
Page 35 of 64
Fig.
Page 36 of 64
Fig.
Page 37 of 64
Fig.
Page 38 of 64
Fig.
Page 39 of 64
Fig.
Page 40 of 64
Fig.
Page 41 of 64
Fig.
Page 42 of 64
Fig.
Page 43 of 64
Fig.
Page 44 of 64
Fig.
OSSEOUS HEMANGIOMA:
Page 45 of 64
Fig.
Page 46 of 64
Fig.
Page 47 of 64
Fig.
Page 48 of 64
Fig.
Page 49 of 64
Fig.
Page 50 of 64
Fig.
Page 51 of 64
Fig.
Page 52 of 64
Fig.
Page 53 of 64
Fig.
Page 54 of 64
Fig.
Page 55 of 64
Fig.
Page 56 of 64
Fig.
Page 57 of 64
Fig.
Page 58 of 64
Fig.
Page 59 of 64
Fig.
Page 60 of 64
Fig.
Page 61 of 64
Fig.
Page 62 of 64
Fig.
Conclusion
Imaging studies are essential for the evaluation of the vascular processes affecting the
orbit.
Location, age patient and characteristics on MR imaging are key facts that can help
narrow the differential diagnosis, thereby helping to guide patient treatment.
Personal Information
Page 63 of 64
Department of Radiology, Hospital Universitario Central de Asturias, Oviedo, Spain
References
Page 64 of 64