Diagnosing Distensible Venous Malformations of the Orbit With Diffusion-weighted Magnetic Resonance Imaging

Evan Kalin-Hajdu*, John B. Colby, Oluwatobi Idowu, F. Lawson Grumbine, Jessica M. Kang, Kristin S. Hirabayashi, Christine M. Glastonbury, M. Reza Vagefi, Robert C. Kersten

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Purpose: To compare the diffusion-weighted imaging of nonthrombosed distensible venous malformations of the orbit with that of other histologically-proven orbital tumors. Design: Retrospective case-control study. Methods: Patients with nonthrombosed distensible venous malformations of the orbit and patients with other histologically-proven orbital tumors were selected for chart review. The main outcome measure was the apparent diffusion coefficient of these lesions. Results: Sixty-seven patients qualified for chart review; 9 patients had nonthrombosed distensible venous malformations and 58 patients had other histologically-proven tumors. Three of the 9 patients with nonthrombosed distensible venous malformations were initially misdiagnosed as having had solid orbital tumors. The mean apparent diffusion coefficient of distensible venous malformations was 2.80 ± 0.48 × 10−3 mm2/s, whereas the mean apparent diffusion coefficient of other histologically-proven tumors was 1.18 ± 0.39 × 10−3 mm2/s (P <.001). The mean apparent diffusion coefficient ranged from 2.42 to 3.94 × 10−3 mm2/s in the distensible venous malformation group, whereas other histologically-proven tumors ranged from 0.53 to 2.08 × 10−3 mm2/s. Therefore, in this single-institution series, a threshold value of 2.10 × 10−3 mm2/s was 100% sensitive and 100% specific for distensible venous malformations. Conclusion: Certain nonthrombosed distensible venous malformations can evade diagnostic suspicion and mimic solid orbital tumors on standard magnetic resonance imaging sequences. In this single-institution series, diffusion-weighted imaging effectively distinguished these nonthrombosed distensible venous malformations from other orbital tumors.

Original languageEnglish (US)
Pages (from-to)146-154
Number of pages9
JournalAmerican journal of ophthalmology
Volume189
DOIs
StatePublished - May 2018
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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