Sector B-scan ultrasonographic 'hemangiomalike' pattern

Area of Science:

• Ophthalmology
• Medical Imaging
• Diagnostic Ultrasound

Background:

• Unilateral exophthalmos is a clinical sign requiring accurate diagnosis of the underlying orbital lesion.
• Ultrasonography is a valuable non-invasive tool for evaluating orbital masses.
• Distinguishing between different orbital pathologies based solely on imaging can be challenging.

Purpose of the Study:

• To evaluate the ultrasonographic pattern of orbital masses in patients presenting with unilateral exophthalmos.
• To determine the specificity of the observed ultrasonographic pattern for cavernous hemangioma of the orbit.

Main Methods:

• Sector B-scan ultrasonography was performed on eleven patients with unilateral exophthalmos.
• Ultrasonographic findings were analyzed for characteristics such as mass shape, borders, reflectivity, and sound transmission.
• Postoperative histopathological examination was used to confirm the diagnosis of orbital lesions in a subset of patients.

Main Results:

• All eleven ultrasonograms demonstrated a consistent "hemangioma-like" pattern.
• This pattern was characterized by a rounded, well-outlined mass with a sharp anterior border, moderate to strong reflectivity, and fair to good sound transmission.
• While six cases were pathologically confirmed as cavernous hemangioma, similar patterns were observed in hemangiopericytoma, lymphangioma, orbital varix, meningioma, and mixed cell tumors.

Conclusions:

• The "hemangioma-like" pattern on sector B-scan ultrasonography is a common finding in various orbital masses causing unilateral exophthalmos.
• This ultrasonographic pattern is not specific for cavernous hemangioma and can be seen in other orbital lesions.
• Differential diagnosis of orbital masses requires correlation of ultrasonographic findings with clinical presentation and potentially other imaging modalities or biopsy.