T2 Fluid-Attenuated Inversion Recovery Imaging of Uveal Melanomas and Other Ocular Pathology

Abstract

Background/Aims: This study describes patterns of intraocular lesions on T2 fluid-attenuated inversion recovery (FLAIR) imaging, exploring a prospective role of FLAIR imaging sequence in diagnosis and treatment. Methods: A retrospective study of orbital magnetic resonance imaging (MRI) studies from the years 2000 to 2015 was performed. MRI sequences included: pre-contrast T1-weighted, T2-weighted, T2 FLAIR, and postcontrast T1 and T2 imaging gadolinium, which were evaluated by a neuroradiologist. Two cases of melanoma were correlated to their pathology. Results: Twenty-four patients with intraocular pathology were evaluated. All lesions, regardless of pigmentation, revealed previously described melanotic patterns on T1- and T2-weighted images; 80% of 10 melanomas localized were hyperintense on T2 FLAIR, which better delineated lesion margins. All of the four inflammatory pathologies on T2 FLAIR were hyperintense, as were 80% of the amelanotic neoplasms. Pathology of two large uveal melanomas paralleled the findings seen on T2 FLAIR. Conclusions: T2 FLAIR appears beneficial in the demarcation of pigmented ocular lesions and may aid in determining protein content or previous treatment. Data also promote previous assertions that blood flow impacts intensity of lesions on T2 FLAIR. Further research is warranted.

Imaging features of retinal hemangioblastoma: A case report

“…It shows progressive significant enhancement after contrast enhancement. PET metabolism suggests that choroidal hemangioma usually has no change in glucose uptake[ 20 , 21 ]. Therefore, enhanced dynamic delayed scanning is of great significance in the diagnosis and differentiation of choroidal hemangioma.…”

Response Evaluation of Choroidal Melanoma After Brachytherapy Using Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI): Preliminary Findings

“…In the present study, we evaluated the use of DW-MRI in the response evaluation of patients with choroidal melanoma undergoing brachytherapy. Other authors have demonstrated the use of other MRI sequences to characterize melanomas, such as the T2 FLAIR sequence and post-contrast sequences to assess vascularization and perfusion of the lesion (37,38). In our work, we used a more objective protocol and intravenous MRI contrast was not administered for two reasons.…”

Magnetic Resonance Imaging in the Clinical Care for Uveal Melanoma Patients—A Systematic Review from an Ophthalmic Perspective

“…In contrast to retinal detachment, necrosis and inflammation are better depicted on T2weighted imaging, as is illustrated in Figure 3 [22,56]. Using the aforementioned features, The signal intensity characteristics of UM on these types of MR-images have been described extensively [10,11,26,28,34,36,37,45,56,[59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76]. As almost all intraocular lesions, including UM, are hyperintense on T1-and hypointense on T2-weighted imaging compared to the vitreous, Ferreira [28] proposed to use the choroid and nearby extraocular muscle as reference on T1-and on T2-weighted imaging, respectively.…”