MR dacryocystography: Comparison with dacryocystography and CT dacryocystorgaphy

BACKGROUND AND PURPOSE: Several techniques have been used to image the naso lacrimal system, providing functional (dacryoscintigraphy) or morphologic ( dacryocystography, CT dacryocystography [CTD]) information, Using gadopente tate dimeglumine-diluted solution injected into the lacrimal canaliculus or instilled into the conjunctival sac, we compared the sensitivity of MR dac ryocystography (MRD) with that of CTD, METHODS: Eleven healthy volunteers and 25 patients affected by primary epip hora (21 patients) or postsurgical recurrent epiphora (four patients) under went MRD after the topical administration of contrast media or cannulation of the lacrimal canaliculus. The MR imaging findings were compared with irr igation and CTD data. All patients underwent surgical treatment (dacryocyst orhinostomy), which served as a standard of reference for confirming the MR D findings. RESULTS: The topical administration of contrast-enhanced saline solution an d the injection of contrast-enhanced saline solution after cannulation were always well tolerated, In healthy volunteers, outflow of contrast media wa s always revealed by MRD. Eight (32 %) of 25 patients with epiphora had ste nosis proximal to the lacrimal sac revealed by MRD, whereas 17 (68 %) of 25 showed a dilated lacrimal sac and nasolacrimal duct stenosis, as confirmed by surgical findings, The findings of MRD after the topical administration of contrast medium and MRD after cannulation of the lacrimal canaliculus w ere comparable with irrigation or CTD data for all patients except one. CONCLUSION: In patients with epiphora, MR imaging performed after the topic al administration of diluted contrast material can reveal stenosis of the l acrimal apparatus and can be added to the standard orbital imaging protocol when lacrimal system involvement is suspected.