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Updated: May 26, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
MR dacryocystography in the evaluation of patients with obstructive epiphora treated by means of interventional
1Department of Radiology, School of Medicine, Gazi University, Besevler, Ankara-Turkey. bcoskun@gazi.edu.tr
Background And Purpose:
Most imaging techniques used for the evaluation of obstructive epiphora, such as DS DCG, rely on undesired ionizing radiation. We evaluated the efficacy of topical contrast-enhanced MR DCG in comparison with DS DCG in patients with obstructive epiphora who underwent balloon DCG or stent placement.
Materials And Methods:
Thirty-six LDSs of 21 patients treated with balloon DCG (n = 11) or stent placement (n = 11) were examined with MR DCG and DS DCG. Contralateral LDSs (n = 14) were also evaluated in patients with unilateral disease. A sterile 0.9% NaCl solution containing 1:100 diluted gadolinium chelate was instilled into conjunctival sacs. The 3D FSPGR sequence was used with a 1.5T scanner. MR and DS DCG findings were scored and compared according to morphology of the lacrimal sac, junction, and NLD and the presence of contrast media in the nasal cavity.
Results:
Comparison of MR DCG and DS DCG findings showed no significant statistical differences in reference to anatomic locations according to the McNemar test (P > .05). Good or very good agreement (κ value > 0.61) was observed according to the κ statistics.
Conclusions:
Topical contrast-enhanced MR DCG is an effective and reliable noninvasive method for evaluation of the LDS in patients treated with IR procedures. This method avoids both cannulation and ionizing radiation and can, therefore, be repeated as often as is necessary in these complex patients.
Insights
Topical contrast-enhanced MR dacryocystography (DCG) effectively evaluates the lacrimal drainage system without ionizing radiation. This noninvasive method offers reliable results comparable to traditional DS DCG for obstructive epiphora.
Area of Science:
- Ophthalmology
- Radiology
- Medical Imaging
Background:
- Obstructive epiphora evaluation often uses dacryocystography (DCG) with ionizing radiation.
- Alternative non-ionizing imaging methods are sought for patient safety and repeated assessments.
Purpose of the Study:
- To compare the efficacy of topical contrast-enhanced magnetic resonance dacryocystography (MR DCG) with conventional dye-based DCG (DS DCG).
- To assess MR DCG in patients with obstructive epiphora undergoing lacrimal drainage system (LDS) interventions.
Main Methods:
- MR DCG and DS DCG were performed on 36 LDSs from 21 patients treated with balloon DCG or stent placement.
- Gadolinium chelate solution was instilled topically, and imaging was acquired using a 1.5T scanner with a 3D FSPGR sequence.
- Findings were scored based on lacrimal sac, junction, NLD morphology, and contrast in the nasal cavity.
Main Results:
- No statistically significant differences were found between MR DCG and DS DCG findings regarding anatomical locations (P > .05).
- Good to very good agreement (κ > 0.61) was observed between the two imaging modalities.
Conclusions:
- Topical contrast-enhanced MR DCG is a noninvasive, effective, and reliable method for evaluating the LDS post-interventional radiology (IR) procedures.
- This technique avoids ionizing radiation and cannulation, allowing for frequent, necessary repeat examinations in complex cases.
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