TY - JOUR
T1 - Multimodality Image-Guided Sclerotherapy of Low-Flow Orbital Vascular Malformations
T2 - Report of Single-Center Experience
AU - Harmoush, Samer
AU - Chinnadurai, Ponraj
AU - El Salek, Kamel
AU - Metwalli, Zeyad
AU - Herce, Honey
AU - Bhatt, Amit
AU - Steinkuller, Paul
AU - Vece, Timothy
AU - Siddiqui, Shakeel
AU - Pimpalwar, Ashwin
AU - Marx, Douglas
AU - Mawad, Michel
AU - Pimpalwar, Sheena
N1 - Publisher Copyright:
© 2016 SIR.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Purpose To evaluate the role of multimodality imaging tools for intraprocedural guidance and outcome evaluation during sclerotherapy of low-flow orbital vascular malformations. Materials and Methods A retrospective review was performed of 17 consecutive patients with low-flow orbital malformations (14 lymphatic, two venous, and one venolymphatic) who underwent multimodality image-guided sclerotherapy between November 2012 and May 2015. Sclerotherapy technique, image guidance tools, and complications were recorded. Sclerotherapy outcome was evaluated using clinical response, magnetic resonance (MR) image-based lesion volumetry, and proptosis quantification. Results There were 22 sclerotherapy sessions performed. Intraprocedural ultrasound (US), fluoroscopy, cone-beam computed tomography (CT) and MR image fusion were used for image guidance with 100% technical success. Resolution of presenting symptoms was observed in all patients at 1-month follow-up. Four major sclerotherapy complications were successfully managed. Statistically significant reduction in lesion volume (P =.001) and proptosis (P =.0117) by MR image analysis was achieved in all patients in whom 3-month follow-up MR imaging was available (n = 13/17). There was no lesion recurrence at a median follow-up of 18 months (range, 8-38 mo). Conclusions Multimodality imaging tools, including US, fluoroscopy, cone-beam CT, and MR fusion, during sclerotherapy of low-flow orbital malformations provide intraprocedural guidance and quantitative image-based evaluation of treatment outcome.
AB - Purpose To evaluate the role of multimodality imaging tools for intraprocedural guidance and outcome evaluation during sclerotherapy of low-flow orbital vascular malformations. Materials and Methods A retrospective review was performed of 17 consecutive patients with low-flow orbital malformations (14 lymphatic, two venous, and one venolymphatic) who underwent multimodality image-guided sclerotherapy between November 2012 and May 2015. Sclerotherapy technique, image guidance tools, and complications were recorded. Sclerotherapy outcome was evaluated using clinical response, magnetic resonance (MR) image-based lesion volumetry, and proptosis quantification. Results There were 22 sclerotherapy sessions performed. Intraprocedural ultrasound (US), fluoroscopy, cone-beam computed tomography (CT) and MR image fusion were used for image guidance with 100% technical success. Resolution of presenting symptoms was observed in all patients at 1-month follow-up. Four major sclerotherapy complications were successfully managed. Statistically significant reduction in lesion volume (P =.001) and proptosis (P =.0117) by MR image analysis was achieved in all patients in whom 3-month follow-up MR imaging was available (n = 13/17). There was no lesion recurrence at a median follow-up of 18 months (range, 8-38 mo). Conclusions Multimodality imaging tools, including US, fluoroscopy, cone-beam CT, and MR fusion, during sclerotherapy of low-flow orbital malformations provide intraprocedural guidance and quantitative image-based evaluation of treatment outcome.
KW - Abbreviations DAP dose area product
KW - IOP intraocular pressure
KW - STS sodium tetradecyl sulfate
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U2 - 10.1016/j.jvir.2016.02.036
DO - 10.1016/j.jvir.2016.02.036
M3 - Article
C2 - 27184528
AN - SCOPUS:84973444251
SN - 1051-0443
VL - 27
SP - 987-995.e4
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 7
ER -