Article Figures & Data
Figures
- Fig 1.
DS and MR DCG 12-year follow-up after balloon DCG in an asymptomatic patient. A, DS DCG reveals occlusion of the distal NLD (arrow) and reflux of iodinated contrast material to the conjunctival sac (asterisk). B, DS DCG immediately after transluminal balloon dilation shows passage of the contrast media to the inferior meatus of the nasal cavity (arrow). Note that there is no reflux to the conjunctival sac after successful balloon DCG. C, Twelve-year DS-DCG follow-up with bilateral simultaneous contrast media injection reveals a completely normal LDS. The anatomic regions of the normal left LDS are the following: 1) inferior canaliculus, 2) lacrimal sac, 3) NLD, and 4) contrast media in the nasal cavity. D, Bilateral topical contrast-enhanced coronal MIP DCG image from 3D FSPGR sequence demonstrates patency of the LDSs both on the intervened right side and normal left side. 1 indicates the canaliculi; 2, lacrimal sac; 3, nasolacrimal duct; 4, contrast media in the nasal cavity.
- Fig 2.
Evaluation of both LDSs with recurrent epiphora treated with multiple balloon DCGs. A, DS DCG shows patency of the both LDSs in the fifth year of follow-up after the last intervention. B and C, Coronal MIP MR DCG from coronal (B) and axial (C) images shows patent LDSs with luminal irregularities and contrast media in the nasal cavity (arrows).
- Fig 3.
MR DCG evaluation of bilateral LDSs treated with nasolacrimal stents 4 years before the examination. A, Bilateral DS DCG reveals severe nasolacrimal stenoses on both sides (arrows) with prominent dilation of the left lacrimal sac (arrowhead). B, The fourth-year follow-up DS DCGs show the patent lumens of polyurethane nasolacrimal stents (white arrows) in the LDSs with free flow of contrast media to the nasal cavity on both sides. C, Coronal MIP DCG image from an axial FSPGR sequence demonstrates the patency of the stent lumens on both sides.
- Fig 4.
Discrepancy of the MR and DS DCG in the asymptomatic patient who had been treated with balloon DCG. A and B, MR DCG reveals normal right LDS (A), and there is no obvious difference after the sac massage (B). C, MR DCG findings could not be confirmed at the DS DCG showing stenosis of the junction and NLD (arrow) with a dilated lacrimal sac (arrowhead).
- Fig 5.
Junctional stenosis in patient having grade 1 epiphora. A, MR DCG shows occlusion at the nasolacrimal junction (arrow) with a dilated lacrimal sac on the right. The left LDS is normal. B, After the lacrimal sac massage, there is no difference on the right and drainage of the left LDS with free flow of contrast media. C, DS DCG reveals severe junctional stenosis (black arrow) with dilation of the lacrimal sac (arrowhead). Passage of the contrast media to the nasal cavity is obvious (white arrow).
Tables
No. Age (yr) Sex Epiphoraa (grade) Intervention Time Intervalb (yr) BD Stent R L R L R L R L 1 65 F 0 0 – + – – – 12 2 39 F 0 1 – – + + 4 4 3 44 F 0 0 – – + – 5 – 4 40 F 1 0 + – – – 9 – 5 59 F 1 0 – – +c – 5 – 6 56 M 0 0 + – – – 1 – 7 44 M 0 0 – + – – – 1 8 42 F 0 0 – + – 4 – 9 38 F 0 0 – – +c – 5 – 10 59 F 0 0 – – – +c – 4 11 43 F 0 5 – – – +c – 4 12 60 F 2 2 + – – – 5 – 13 63 F 0 0 + – – – 12 – 14 47 F 0 0 + – – – 10 15 47 F 0 0 + – – – 11 – 16 37 F 1 0 + – – – 11 – 17 63 F 0 0 + – – – 7 – 18 53 M 0 0 – – +c – 5 – 19 43 F 0 3 – – – + – 10 20 73 M 0 0 – + – – – 7 21 38 F 0 0 – – – + – 1 Series No. View FOV (cm) TR (ms) TE (ms) Matrix Thickness (mm) NEX FA (°) Duration (min) 1 Coronal 10 11 2.7 320 × 256 1 2 20 3 2 Axial 10 11 2.7 320 × 256 1 2 20 4.5 3 Coronal (postmassage) 10 11 2.7 320 × 256 1 2 20 3 -
Note:—FA = flip angle.
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Lacrimal sac Small (1) Normal (2) Dilated (3) – Sac-NLD junction Obstructed (1) Stenotic (2) Normal (3) Dilated (4) Stent Obstructed (1) Stenotic (2) Normal (3) – NLD Obstructed (1) Stenotic (2) Normal (3) Dilated (4) Contrast media in the nasal cavity Nonexistent (0) Existent (1) – – -
Note:– indicates absent.
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- Table 4:
Results of the statistical analysis in terms of κ values for all LDSs and intervened LDSs
All LDSs (n = 36) Intervened LDSs (n = 22) Lacrimal sac 0.844 0.842 Junction 0.826 0.752 NLD 0.814 0.768 CM in nasal cavity 0.786 0.776 -
Note:—CM indicates contrast media.
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Patient No. Diagnosis Method Lacrimal Sac Junction NLD CM in the NC 1 DS DCG Normal Stenotic Normal + MR DCG Normal Stenotic Stenotic + 6 DS DCG Dilated Normal Normal + MR DCG Dilated Stenotic Normal + 12 DS DCG Normal Normal Normal + MR DCG Dilated Normal Normal + 15 DS DCG Dilated Stenotic Stenotic + MR DCG Normal Normal Normal + 16 DS DCG Dilated Stenotic Stenotic + MR DCG Dilated Obstructed NA – -
Note:—CM indicates contrast media; NC, nasal cavity; +, existent; –, nonexistent.
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Study Year No. of Patients Cannulation Topical Sequence Technique Goldberg et al6 1993 11 Gd-DTPA Gd-DTPA T1WI (fat-sat) Caldemeyer et al21 1998 11 – Saline solution FSE T2WI Kirchhof et al28 2000 11 – Gd-DTPA T1- and T2WI (fat-sat) Manfre et el29 2000 36 Gd-DTPA Gd-DTPA SE T1WI (fat-sat) Yoshikawa et al25 2000 18 Gd-DTPA Saline solution FSE T2WI; SE T1WI Takehara et al31 2000 8 Saline solution – Heavily T2WI Karagülle et al24 2002 19 Gd-DTPA – 3D FSPGR Cubuk et al32 2010 35 Saline solution – Single-shot SE T2WI (fat-sat) Our study 2011 21 – Gd-BT-DO3A 3D FSPGR -
Note:—fat-sat indicates fat-saturated; SE, spin-echo; –, absent.
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