Correlation Between IVIM-DWI Parameters and Pathological Classification of Idiopathic Orbital Inflammatory Pseudotumors: A Preliminary Study.

Jian Pu,Shun-Jun Ji,Ying-Wen Li,Qian He,Yi Liang,Min-Jie Zhou,Jian-Bo Li,Ju-Wei Shao,Shu-Tian Xiang

doi:10.3389/fonc.2022.809430

Abstract

ObjectiveTo investigate the correlation between intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and the pathological classification of idiopathic orbital inflammatory pseudotumors (IOIPs).MethodsNineteen patients who were diagnosed with IOIPs (a total of 24 affected eyes) between November 2018 and December 2020 were included in the study. All the patients underwent magnetic resonance imaging orbital plain scans and IVIM-DWI multiparameter scans before an operation. The true diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values were obtained. Based on histopathology, the lesions were divided into three types: lymphocytic infiltration, fibrosclerotic, and mixed. The correlation between IVIM-DWI parameters and pathological classification was tested with the histopathological results as the gold standard. The data were analyzed using SPSS version 17.0, with P < 0.05 defined as significant.ResultsAmong the 19 patients (24 eyes) affected by IOIP, there were no significant differences between IOIP pathological classification and gender or age (P > 0.05). There were statistically significant differences between the D and f values for different pathological types of IOIP and IVIM parameters (P < 0.05), and there was no significant difference in D* value between the different pathological types (P > 0.05).ConclusionThe D and f values showed correlation with different types of IOIP, and the sensitivity of the D value was higher than that of the f value. The D* value showed no significant distinction between pathological types of IOIP.

Highlights

Idiopathic orbital inflammatory pseudotumors (IOIPs) are a nonspecific type of orbital inflammatory disease
There was no correlation between sex, age, and pathological type of IOIP (P > 0.05) (Table 1)
The analysis of variance of D value and f value in IOIP typing showed that the F values were 25.464 and 7.605, respectively

Summary

Introduction

Idiopathic orbital inflammatory pseudotumors (IOIPs) are a nonspecific type of orbital inflammatory disease. Orbital inflammatory disease is the third most prevalent type of orbital lesion [1], accounting for 9% of cases [2]. According to the different proportions of chronic inflammatory cell infiltration and fibrous tissue hyperplasia in the pathological tissues, IOIP can be classified into a diffuse lymphocytic infiltration type, a mixed type, and a fibrosclerotic type [3]. The pathological type is closely related to the choice of treatment method [4]. The current treatment options include corticosteroid therapy, surgical resection, and radiology therapy [5, 6]. The lymphocytic infiltration type is sensitive to corticosteroid therapy, while the mixed and fibrosclerotic types show poor response to corticosteroid therapy and have high recurrence rates [7, 8]. It is important to clarify the pathological classification of IOIPs before clinical intervention [10, 11] to help select the most suitable clinical treatments

Methods

Results

Discussion

Conclusion