Uveal melanoma MRI: Difference between revisions

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==Overview==
==Overview==
Head and neck MRI may be helpful in the diagnosis of uveal melanoma. Head and neck MRI scan is diagnostic of uveal melanoma. On [[head]] and [[neck]] [[MRI]], uveal melanoma is characterized by isointense to hypointense mass on T1-weighted MRI and hyperintense mass on T2-weighted MRI.<ref name="radio">  Retinoblastoma. Radiopedia(2015) http://radiopaedia.org/articles/primary-uveal-malignant-melanoma Accessed on October 21, 2015</ref>
Head and neck MRI may be helpful in the diagnosis of uveal melanoma. Head and neck MRI scan is diagnostic of uveal melanoma. On [[head]] and [[neck]] [[MRI]], uveal melanoma is characterized by isointense to hypointense mass on T1-weighted MRI and hyperintense mass on T2-weighted MRI.<ref name="radio">  Retinoblastoma. Radiopedia(2015) http://radiopaedia.org/articles/primary-uveal-malignant-melanoma Accessed on October 21, 2015</ref>
==MRI==
==MRI==
MRI is the modality of choice for assessment of malignant uveal melanomas 5-6.
MRI is the modality of choice for assessment of malignant uveal melanomas.<ref name="radio">  Retinoblastoma. Radiopedia(2015) http://radiopaedia.org/articles/primary-uveal-malignant-melanoma Accessed on October 21, 2015</ref>
 
T1 or PD
uveal melanomas are seen as moderately high signal mass lesion
associated exudative retinal detachment is moderately high signal
T2
moderately low signal mass lesion
associated exudative retinal detachment is moderately high signal
haemorrhagic subretinal fluid has variable signal pattern
T1 C+ (Gd)
tumours enhance
fat suppression useful in detecting extraocular extention
 
[[MRI]] is the modality of choice for pre-treatment staging on retinoblastoma.
*The MRI features of retinoblastoma include:<ref name="radio">  Retinoblastoma. Radiopedia(2015) http://radiopaedia.org/articles/retinoblastoma Accessed on October 10, 2015</ref>
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:T1
:T1 or Proton Density
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*Intermediate signal intensity, hyperintense c.f. vitreous
*Uveal melanomas are seen as moderately high signal mass lesion
*Associated exudative retinal detachment is moderately high signal
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:T2
:T2
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*Hypointense c.f. vitreous
*Moderately low signal mass lesion
*Associated exudative retinal detachment is moderately high signal
*Haemorrhagic subretinal fluid has variable signal pattern
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:T1 contrast with gadolinium
:T1 contrast with gadolinium
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*The mass usually enhances relatively homogeneously when small
*Tumors enhance
*Larger tumors often have areas of necrosis, rendering it heterogeneous
*Fat suppression useful in detecting extraocular extention
*Linear enhancement of the choroid beyond the margins of the tumour should raise the possibility of choroidal involvement, although inflammation may lead to similar appearance
*Enhancement of the anterior chamber need not represent tumour involvement, with hyperaemia, uveitis and iris neovascularisation all leading to asymmetric enhancement
*Careful assessment of the optic disc and optic nerve should be carried out to assess for involvement
*Extra-ocular extension through the sclera will be visible as interruption of the otherwise hypointense non-enhancing sclera by enhancing tumour
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:Diffusion Weighted Imaging
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*The tumour shows restricted diffusion on DWI at high b values. It exhibits low ADC values in contrast to the high intensity of the vitreous in the ADC maps
*ADC map can be used to differentiate viable and necrotic tumour
*DWI is valuable in evaluating the response to eye-preservation treatment
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Revision as of 14:05, 22 October 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Head and neck MRI may be helpful in the diagnosis of uveal melanoma. Head and neck MRI scan is diagnostic of uveal melanoma. On head and neck MRI, uveal melanoma is characterized by isointense to hypointense mass on T1-weighted MRI and hyperintense mass on T2-weighted MRI.[1]

MRI

MRI is the modality of choice for assessment of malignant uveal melanomas.[1]

MRI component Features
T1 or Proton Density
  • Uveal melanomas are seen as moderately high signal mass lesion
  • Associated exudative retinal detachment is moderately high signal
T2
  • Moderately low signal mass lesion
  • Associated exudative retinal detachment is moderately high signal
  • Haemorrhagic subretinal fluid has variable signal pattern
T1 contrast with gadolinium
  • Tumors enhance
  • Fat suppression useful in detecting extraocular extention


References

  1. ↑ 1.0 1.1 Retinoblastoma. Radiopedia(2015) http://radiopaedia.org/articles/primary-uveal-malignant-melanoma Accessed on October 21, 2015

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