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Comparing the diagnostic accuracy of MR dacryocystography (MRD) and dacryoscintigraphy (DSG) in NLDO-related acquired epiphora

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Abstract

Propose

This study aimed to compare the diagnostic accuracy of MR dacryocystography (MRD) and dacryoscintigraphy (DSG) in the diagnosis of acquired epiphora related to NLDO. A total of 15 patients with acquired epiphora and suspected NLDO were included in this study.

Methods

All patients underwent MRD and DSG examinations. MRD was performed using a 3-Tesla magnetic resonance imaging (MRI) scanner, while DSG involved injection of a radiotracer into the lacrimal drainage system followed by DSG. The results of both imaging methods were compared with the reference standard that was a combination of clinical examination findings and surgical exploration.

Results

The results of this study showed that no abnormal findings were observed in MR-DCG in patients before the Valsalva maneuver. However, after the Valsalva maneuver, stenosis/obstruction at the canal surface was observed in all 15 patients diagnosed by DSG, giving a sensitivity of 100% for canal stenosis. Moreover, the results revealed that among these 15 patients, 9 showed stenosis or simultaneous obstruction at the level of the canal and lacrimal sac, but MR-DCG showed these lesions in only 9 patients, giving a sensitivity of 60%. The specificity of MRD and DSG were 85% and 76.7%, respectively. There was a statistically significant difference in the sensitivity of MRD and DSG (p < 0.05).

Conclusion

This study demonstrated that MRD has a higher diagnostic accuracy in the diagnosis of acquired epiphora associated with NLDO compared to DSG. MRD showed significantly higher sensitivity and specificity than DSG. Therefore, MRD can be considered as the preferred imaging modality in the diagnosis of acquired epiphora due to NLDO. By accurately identifying the underlying cause of NLDO, MRD can help determine the most appropriate treatment approach for patients and lead to better outcomes.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Medical Radiation Sciences Research Team, Tabriz University of Medical Sciences, Tabriz, Iran

    Ali Abzirakan Aslanduz, Babak Mahmoudian & Amirreza Jahanshahi

  2. Department of Ophthalmology, Tabriz University of Medical Sciences, Tabriz, Iran

    Afshin Lotfi Sadigh

  3. Department of Dermatology, Faculty of Medicine, Tabriz Islamic Azad University, Tabriz, Iran

    Elham Nahchami

  4. Department of Radiology, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran

    Amirreza Jahanshahi

Authors
  1. Ali Abzirakan Aslanduz
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  2. Babak Mahmoudian
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  3. Afshin Lotfi Sadigh
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  4. Elham Nahchami
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  5. Amirreza Jahanshahi
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Contributions

AAA and AJ researched data, performed statistical analyses, contributed to interpretation, edited the manuscript, and contributed to discussion; BM drafted the manuscript and edited the manuscript after comments from co-authors, ALS and EN contributed to interpretation, edited the manuscript, and contributed to discussion. The study was designed by all authors.

Corresponding author

Correspondence to Amirreza Jahanshahi.

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Conflict of interest

The authors of this manuscript have no conflict of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study was approved by the ethical board of the medical-educational center. The study was also approved by the ethics committee of Tabriz University of Medical Sciences (ethics code: IR.TBZMED.REC.1400.212).

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Appendix 1: information collection form

Appendix 1: information collection form

Title: Comparison of diagnostic value of MR dacryocystography with and without Valsalva maneuver with dacryoscintigraphy in patients with acquired epiphoria.

Item

Response

Yes

No

Positive MR dacryocystography with Valsalva maneuver

  

Positive MR dacryocystography without Valsalva maneuver

  

Positive dacryoscintigraphy with Valsalva maneuver

  

Positive dacryoscintigraphy without Valsalva maneuver

  

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Aslanduz, A.A., Mahmoudian, B., Sadigh, A.L. et al. Comparing the diagnostic accuracy of MR dacryocystography (MRD) and dacryoscintigraphy (DSG) in NLDO-related acquired epiphora. Int Ophthalmol 44, 88 (2024). https://doi.org/10.1007/s10792-024-02932-1

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