Echographic Differentiation of Vascular Tumors in the Orbit

Abstract

With standardized echography, based on the standardized A-scan method and aided by contact B-scan and Doppler techniques, all orbital lesions causing symptoms or signs can be detected reliably and accurately. With standardized echography, orbital lesions can be differentiated into 70 types of lesions or groups of conditions; the sensitivity of standardized echography in this differential diagnosis exceeds 90%, and its accuracy is more than 80%. Vascular orbital tumors (both neoplasms and malformations) are among the most thoroughly studied lesions in echographic differential diagnosis. With standardized echography, they can be subdivided into ten individual types or groups of lesions. They are: typical cavernous hemangiomas occurring in adults; highly sclerosed cavernous hemangiomas in adults; hemangiomas of the mixed (capillary and cavernous) type occurring in infants; cavernous hemangiomas in infants; the group of capillary hemangiomas hemangioendotheliomas, hemangio-pericytomas, angiofibromas and angiosarcomas (which cannot be further differentiated into individual lesions); lymphangiomas; A-V malformations (arteriovenous aneurysms of the orbit); varices; large ‘high-flow’ A-V fistulas of the brain that drain through the orbit and produce pathognomonic echographic patterns; and small ‘low-flow’ A-V fistulas of the brain that congest the orbit and produce characteristic echo-graphic signs which differ from the high-flow fistulas.