Head and Neck Imaging.
Ehab Abo-Ulfotouh Helal.
Lecture Of Radio-Diagnosis.
Mass effect on the orbits can lead to clinical
presentations such as:
- Proptosis, pulsatile or non.
- Orbital pain
- Visual loss.
Can alter the normal orbital blood flow pattern.
Lead to vascular engorgement.
Also known as benign hemangioendothelioma.
Most common orbital vascular tumor in infants.
Entirely extra-conal in location or have a
substantial extra-conal component.
superficial or deep, commonly extend across tissue
planes, and may extend intra-cranially through the
optic canal or superior orbital fissure.
Extraocular muscles and lacrimal glands
occasionally are involved.
Capillary hemangiomas may cause proptosis,
globe displacement, and, occasionally, amblyopia.
expand slightly during crying or straining.
isolated findings or may be found in association
with other manifestations in various syndromes
At MR Imaging:
Iso- to hyper-intense
Lobules with thin septa,
combined with intra-
lesional and peri-lesional
flow voids, characteristic
features on T2-weighted
Also known as cavernous hemangiomas.
Most common vascular lesions in adults.
Manifest with progressive, painless proptosis.
Less common symptoms include pain, lid swelling,
diplopia, a palpable lump, and recurrent episodes of
Nature of cavernous malformations:
- Venous origin.
- low-flow arterio-venous malformations.
Retrobulbar intra-conal space.
Extend intra-cranially through the superior
orbital fissure (5%–10%).
Associations with Maffucci syndrome and blue
rubber bleb nevus syndrome.
On NECT images.
Round or ovoid.
May produce expansion
of orbital walls.
structures but do not
On enhanced CT:
noted in early arterial
part of the lesion on late
At MR imaging.
Isointense to that of
muscle on T1-weighted
Hyperintense to that of
muscle on T2-weighted
Internal septa are visible
within larger lesions.
of contrast material on
late phase delayed
Term lymphangioma commonly applied to this
Referred to as no-flow or low-flow vascular
Evident at birth, but generally manifest in infancy
Slowly progressive proptosis, restriction of eye
movements, or vertical globe displacement, many
manifest abruptly because of hemorrhage.
Multi-compartmental, often including both
intraconal and extraconal components .
Extend across tissue planes, infiltrate the eyelid
and orbit, and cause bone remodeling.
isolated from normal orbital vasculature.
Not affected by postural changes.
MR imaging is the
modality of choice.
Signal intensity of the
lesions depends on type
of fluid within the cystic
components ( T1WIs, Fat
Fluid-fluid levels within