Fig. 8.1
Cavernous hemangioma in right orbit. (a) Axial T1WI MR shows oval homogeneous low intensity in right intraconal space; (b) axial T2WI MR reveals homogeneous hyperintense signal; (c) axial DCE MR shows patchy enhancement within the lesion; (d) axial DCE MR shows that the area of patchy enhancement is bigger than that of (c); (e) axial DCE MR shows that the area of patchy enhancement is bigger than that of (d); (f) oblique-sagittal T1Contrast MR demonstrates homogeneous significant enhancement
Fig. 8.2
Cavernous hemangioma in left orbit. (a) Axial T1WI MR shows oval homogeneous isointensity in left intraconal space; (b) axial T2WI MR reveals homogeneous hyperintense signal; (c) axial T1Contrast MR with fat saturation shows strong patchy enhancement within the lesion; (d) oblique-sagittalT1Contrast MR demonstrates a mass between the superior rectus and the optic nerve; (e) axial DCE MR shows that the selection of ROI; (f) the TIC on DCE MR shows a steady enhancement pattern
8.1.4 Conclusions
Cavernous hemangioma shows soft tissue density on CT and difficultly differentiates with other tumors in orbital cavity.
MRI can show the relationship of lesion with the adjacent structures, according to the characteristic of “progressive enhancement” on DCE MRI; it is not difficult to differentiate from other tumors in intraconal space.
8.2 Lymphangioma
8.2.1 Pathology
- 1.
An irregular mass without capsule composed of lymphatic vessels in different sizes.
- 2.
The lesion is mainly composed of pipelines lining transparent endothelial cells containing serosity and myxoid matrix composition. Old or fresh blood, lymphocyte accumulation, and small vascular dysplasia are also seen (Héran et al. 2014).
8.2.2 Imaging Examination Recommendations
- 1.
CT is the first choice of examination for the clinical suspected lesions.
- 2.
MRI should be undergone to manifest the properties of mass and the relationship with the adjacent structures.
8.2.3 Imaging Findings
CT findings: An irregular or diffusive mass in shape shows heterogeneous iso-hypodensity with or without punctate vein stone; the high density like fluid-fluid level can be found within the lesion if fresh hemorrhage occurs.
MRI findings: The lesion displays heterogeneous intense signal with typical fluid-fluid level due to the hemorrhage in different periods and heterogeneous slight or mild enhancement (Figs. 8.3 and 8.4).
Fig. 8.3
Local lymphangioma in left orbit. (a) Axial T1WI MR shows heterogeneous intensity in irregular shape with fluid-fluid level in left orbit; (b) axial T2WI MR reveals heterogeneous signal with fluid-fluid level; (c) axial T1Contrast MR with fat saturation shows slight peripheral enhancement; (d) coronal T1Contrast MR with fat saturation demonstrates the mass in the superomedial region of the left orbit
Fig. 8.4
Diffusive lymphangioma in right orbit. (a) Axial T1WI MR shows isointense signal in irregular shape with the diffusive involvement of the right intra-extraconal space; (b) coronalT1WI MR reveals ill-circumstance with the adjacent optic nerve and extraocular muscles; (c) axial T2WI MR shows heterogeneous hyperintensity with hypointense septa; (d) axial T1Contrast MR shows heterogeneous slight enhancement
8.2.4 Conclusions
On CT, the lymphangioma shows a soft tissue density in irregular shape; it is difficult for the diffusive lesions to differentiate from other orbital tumors such as varix.
MRI can clearly demonstrate the signal features within the lesions, the characteristic fluid-fluid level, and the relationship with adjacent structures; it is helpful to differentiate from other orbital tumors.
8.3 Capillary Angioma
8.3.1 Pathology
- 1.
The tumor has no capsule; the gray parenchyma of the tumor is in granular appearance and is fragile.
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