Evaluation of MR imaging findings differentiating cavernous haemangiomas from schwannomas in the orbit

Abstract

ObjectiveIt is important to distinguish between orbital cavernous haemangioma and schwannoma because the treatments of choice for the two tumours are different. The aim was to evaluate MR imaging findings distinguishing the two tumours.MethodsMagnetic resonance imaging including T1- and T2-weighted imaging and contrast-enhanced MR imaging was performed in 43 patients with cavernous haemangiomas and 16 patients with schwannomas confirmed by pathology. Location, configuration, margins, signal intensity, homogeneity and enhancement pattern of the tumour were retrospectively evaluated.ResultsThere was a significant difference between cavernous haemangiomas and schwannomas regarding the location, configuration and margins of the mass, signal intensity and homogeneity on T1- and T2-weighted imaging, the spread pattern of contrast enhancement, the enhancement pattern and the type of time–intensity curve (P < 0.05). Markedly homogeneous hyperintensity signal on T2-weighted imaging and the spread pattern of the contrast enhancement favoured cavernous haemangioma rather than schwannoma (P < 0.01).ConclusionCavernous haemangiomas and schwannomas have different MR imaging features that could be helpful in the differentiation between the tumours. The spread pattern of the contrast enhancement on dynamic contrast-enhanced MR imaging is the most reliable finding distinguishing cavernous haemangiomas from schwannomas.

Valuation of Four-Quadrant Location Method in Diagnosis and Differential Diagnosis of the Orbital Tumor by Comparison Study Combining CT and MRI with Pathology

“…The cavernous hemangioma was found in all four quadrants, but among them more cavernous hemangiomas were located in inferolateral quadrant and fewer cavernous hemangiomas were located in superomedial quadrant. Previous studies reported similar result to our study [12][13]. Most of the pleomorphic adenoma, dermoid cyst, lymphoma, adenoid cystic carcinoma and inflammatory pseudotumor, solitary fibrous tumor are located in superolateral quadrant.…”

“…Our study showed that mostly cavernous hemangioma were with well-defined margin, oval/ round shaped, intraconal space, slightly high density, low signal intensity on T1WI, high signal intensity on T2WI and gradual homogeneous enhancement (Figure 2). The previous result was similar finding with our result [12,[17][18][19]. Schwannoma is a rare orbital tumor that from Schwann cell in the peripheral nervous system [20][21][22].…”

MR Evaluation of Sinonasal Angiomatous Polyp

“…Subsequently, contrast enhancement persists in the delayed equilibrium phase, and the enhancing areas increasingly enlarge. 17 Similar enhancement characteristics are shared by cavernous hemangiomas. 18 With regard to the corresponding TIC, an unexpected result was that 70.0% (21/30) of lesions demonstrated the pattern of rapid enhancement and rapid washout (type III) frequently seen in malignancy.…”

Value of MR Imaging in Differentiation between Solitary Fibrous Tumor and Schwannoma in the Orbit

“…It is a peripheral nerve sheath tumor originating purely from Schwann cells. 19,20 The pathologic feature of schwannoma is characteristic, with the tumor composed of Antoni A and Antoni B patterns in variable proportions. The Antoni A pattern appears solid, while the Antoni B pattern shows loose myxomatous tissue.…”

“…12 Although pathologic features of SFT are different from those of schwannoma, orbital SFT and schwannoma show similar clinical findings, making differential diagnosis difficult in clinical practice. 2,3,8,11,19,28 Therefore, a noninvasive method to distinguish SFT from schwannoma in the orbit could be clinically useful, especially in cases in which biopsy would be particularly difficult or the patient is not a good candidate for surgical resection. Many lesions present as round or ovoid masses in the orbit, notably cavernous hemangioma, schwannoma, pleomorphic adenoma of the lacrimal gland, dermoid cyst, and SFT of the orbit.…”