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2016, Number 1

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Anales de Radiología México 2016; 15 (1)

Benign or malignant orbital neoplasms: differential diagnosis by imaging using the diffusion sequence magnetic resonance

Cortés-García BY, Acosta CGI, Villaseñor NY, Delgado HRD

Language: Spanish
References: 13
Page: 39-50
PDF size: 591.22 Kb.


ABSTRACT

Objetive: determine whether quantification of values of the apparent diffusion coefficient, obtained through the DWI sequence, allows us to distinguish benign from malignant orbital tumors.
Material and Method: 45 patients were included with histological diagnosis of orbital tumors, with magnetic resonance and DWI sequence before receiving treatment. The patients were referred from three hospitals: Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Instituto Nacional de Cancerología México, and Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, in the period January 2008 to September 2011. To calculate the apparent diffusion coefficient, a radiologist with 9 years’ experience in head and neck imaging (blind to histopathological diagnosis) selected 5 regions of interest in each patient, of 15 mm2 taken on the area of maximum signal intensity in DWI (in the solid component of each lesion) and obtained an average which was compared with a single measurement. Similarly, region of interest was selected on the ipsilateral thalamus to calculate the apparent diffusion coefficient quotient of the lesion / apparent diffusion coefficient of the thalamus. Apparent diffusion coefficients were compared between malignant and benign tumors by the three methods.
Results: the value of the apparent diffusion coefficient was lower in malignant tumors compared with that found in benign tumors, in a single measurement (0.81 × 10-3 mm2/s vs. 1.31 × 10-3 mm2/s), averaging five measurements (0.80 × 10-3 mm2/s vs. 1.31 × 10-3 mm2/s), and using the apparent diffusion coefficient quotient of the lesion / apparent diffusion coefficient of the thalamus (0.98 × 10-3 mm2/s vs. 1.55 × 10-3 mm2/s), all with values of p ‹ 0.001.
Conclusion: the apparent diffusion coefficient is useful to differentiate between an orbital pseudotumor and an orbital lymphoma, which are the most common benign and malignant orbital neoplasms (respectively).


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