ORIGINAL ARTICLE
DOI 10.1007/s00062-016-0556-6
Clin Neuroradiol (2018) 28:261–266
High Resolution Diffusion-Weighted Imaging for Solitary Orbital
Tumors
3D Turbo Field Echo with Diffusion-Sensitized Driven-Equilibrium (DSDE-TFE)
Preparation Technique
Akio Hiwatashi
1
· Osamu Togao
1
· Koji Yamashita
1
· Kazufumi Kikuchi
1
· Hiroshi Yoshikawa
2
·
Makoto Obara
3
· Hiroshi Honda
1
Received: 15 July 2016 / Accepted: 19 December 2016 / Published online: 17 January 2017
© Springer-Verlag Berlin Heidelberg 2017
Abstract
Purpose To differentiate cystic from solid solitary intraor-
bital tumors using 3D turbo field echo with diffusion-sen-
sitized driven-equilibrium preparation without contrast ma-
terial.
Materials and Methods This retrospective study was ap-
proved by our institutional review boards, and written in-
formed consent was waived. A total of 26 patients with
intraorbital tumors were studied. Motion probing gradients
were conducted at one direction with b-values of 0 and
500 s/mm
2
. The voxel size was 1.5 × 1.5 × 1.5 mm
3
, and ac-
quisition time was 5 min 22 s. Additionally, fat-suppressed
T2-weighted imaging (T2WI) and T1WI were obtained.
The apparent diffusion coefficients (ADC) of the lesions
were measured. Signal intensity on conventional magnetic
resonance imaging (MRI) compared to normal appearing
white matter was also measured. Statistical analysis was
performed with Mann-Whitney U-test, the Steel-Dwass test
and the receiver operating characteristic (ROC) analysis.
Results There were 10 cystic (7 dermoids, 2 epidermoids,
and 1 cystadenoma) and 16 solid (8 cavernous heman-
giomas, 6 pleomorphic adenomas, 1 adenocarcinoma, and
1 sebaceous carcinoma) tumors. The ADC of the cystic
tumors (mean ± SD; 2.21 ± 0.76 × 10
–3
mm
2
/s) was statis-
Akio Hiwatashi
hiwatasi@radiol.med.kyushu-u.ac.jp
1
Department of Clinical Radiology, Graduate School of
Medical Sciences, Kyushu University, 3-1-1 Maidashi,
Higashi-ku, Fukuoka 812-8582, Japan
2
Department of Ophthalmology, Graduate School of
Medical Sciences, Kyushu University, 3-1-1 Maidashi,
Higashi-ku, Fukuoka 812-8582, Japan
3
MR Clinical Science, Philips Electronics Japan, Tokyo, Japan
tically significantly lower than that of solid tumors (1.43 ±
0.41 × 10
–3
mm
2
/s; P <0.05).;however,therewerenosta-
tistically significant differences on conventional MRI (P >
0.05). There were no statistically significant differences
among tumor subtypes in all parameters (P > 0.05). The
ROC analysis showed the best diagnostic performance with
ADC (Az = 0.77).
Conclusion With its insensitivity to field inhomogeneity
and high spatial resolution, the 3D DSDE-TFE technique
enabled us to discriminate cystic tumors from solid tumors.
Keywords Diffusion-weighted imaging · Apparent
diffusion coefficient · Orbit · Tumor
Abbreviation
3D Three dimensional
ADC Apparent diffusion coefficient
DSDE Diffusion sensitized driven equilibrium
preparation
DW Diffusion weighted
EP Echo planar
MR Magnetic resonance
MSDE Motion-sensitized driven-equilibrium
ROC Receiver operating characteristic
ROI Region of interest
TFE Turbo field echo
Introduction
Diffusion-weighted (DW) imaging is widely used to diag-
nose tumors, inflammation, and vascular disease in both
intracranial and extracranial lesions [1–10]. Previous stud-
ies also revealed the efficacy of DW imaging to evaluate
orbital lesions including tumors [1–3], IgG4-related dis-
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