Utility of Multimodal Magnetic Resonance Imaging in Orbital Lymphoma Diagnosis

In this study, the authors investigated the magnetic resonance imaging (MRI) characterization for orbital lymphoma.

The authors collected 57 cases of orbital lymphoma confirmed by surgical pathology, including 38 males and 19 females. All patients underwent conventional MRI transverse T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and contrast-enhanced MRI examinations. The DWI sequences were post-processed to obtain apparent diffusion coefficient (ADC) maps. The location, number, morphology, involvement structure, T1WI, T2WI, DWI, and enhanced T1WI signal intensity were primarily observed on conventional MRI, and the ADC value of the tumor area was calculated using the ADC map.

Among the 57 cases of orbital lymphomas, 31 patients had a unilateral single lesion, 11 had unilateral multiple lesions, and 15 had bilateral multiple lesions. The lesions were primarily located in the eyelids, orbits, conjunctiva, lacrimal glands, and inner canthus regions; among which 32 patients had lesions in the soft tissues of the eyelids, and the extraocular muscles were involved along the muscular cone space, developing into a cast shape, which was the most common. With respect to gray matter, 35 cases displayed isointense T1WI signals, 22 cases displayed slightly hyperintense T1WI signals, 37 cases displayed isointense T2WI signals, and 20 cases displayed slightly hyperintense T2WI signals. All DWI signals were hyperintense, whereas all ADC signals were hypointense. There were 29 cases of moderate enhancement and 7 cases of significant enhancement, with an average ADC value of 0.627±0.087×10-3 mm2/s. There were 17 cases of type II time-intensity curves (TIC) and 19 cases of type III TIC.

The MRI characterizations of orbital lymphoma are distinctive, the DWI sequence is extremely important, and an ADC value of <0.8×10-3 mm2/s is the specific diagnostic indicator.