1. HEAD AND NECK IMAGING
EHAB ABOU ELFOTOUH. MD.
ORBITAL IMAGING IV

2. CHOROIDAL HEMANGIOMA:
 congenital vascular
hamartomas.
 Manifested in middle-
aged or elderly people.
 Equal distribution in
both sexes.

3. CHOROIDAL HEMANGIOMA:
 solitary choroidal
hemangioma as abenign
vascular neoplasm that
is confined to the
choroid.
 Has ill defined margins.
 Posterior chamber of the
globe.
 Diffuse hemangiomas
occur in Sturge-Weber
syndrome.

4. CHOROIDAL HEMANGIOMA:
 CT imaging:
 Solitary ill-defined
mass.
 Posterior chamber of
the globe.
 High CT attenuation.
 Intense enhancement.
 With or without retinal
detachement.

5. CHOROIDAL HEMANGIOMA:
 At MR imaging:
 A lenticular shape
mass.
 Ill defined margins.
 Posterior chamber.
 Hyperintense to
vitreous on T1-
weighted images.

6. CHOROIDAL HEMANGIOMA:
 On T2WIs, signals
typically hyperintense.
 Usually isointense to
vitreous.
 enhanced intensely
after the administration
of contrast material.

10. CHOROIDAL MELANOMA:
 most common primary
intraocular tumors in
adults.
 Melanomas occur in
any of three
subdivisions of uveaL
tract.
 From preexisting
melanocytic nevi.
 56%of melanomas
occur in those older
than 50 years.

11. CHOROIDAL MELANOMA:
 Tumors initially have a
flat growth profile.
 later become elevated.
 Erupting through the
Bruch membrane with
characteristic
mushroom shape.

12. CHOROIDAL MELANOMA:
 Primarily metastasize
to the liver.
 Some metastases
manifest before
primary tumor
detection.
 In order of decreasing
frequency of distal
metastasis are lung,
bone, kidney, and
brain

13. CHOROIDAL MELANOMA:
 Large melanomas (10
mm thick) managed with
enucleation.
 medium-
 sized lesions (3–10 mm
thick) external-beam
radiationtherapy.
 Small tumors (3 mm
thick) follow up 3–6
months with US or
transpupillary
thermotherapy.

14. CHOROIDAL MELANOMA:
 At unenhanced CT:
 Elevated posterior
chamber mass.
 Hyper-attenuating.
 Sharply marginated.

15. CHOROIDAL MELANOMA:
 At enhanced CT:
 Moderate intense
enhancement.
 With or without retinal
detachment.
 Orbital metastasis.

16. CHOROIDAL MELANOMA:
 At MR imaging:
 Posterior chamber
well-defined solid
mass.
 Melanotic melanomas
have shorter T1 and
T2 relaxation times.
 Increased signal
intensity on
T1WIs.

17. CHOROIDAL MELANOMA:
 Markedly
decreased signal
intensity on
T2WIs.
 Among ocular
tumors, only
melanomas manifest
these signal intensity
character.

18. CHOROIDAL MELANOMA:
 Choroidal melanomas
demonstrate moderate
to strong
enhancement.
 Contrast-enhanced fat-
suppressed MR
imaging demonstrate
scleral
invasion, extension to
optic disc, and

19. CHOROIDAL MELANOMA:
 Amelanotic
melanomas has:
 Isointense with
vitreous on T1WIs.
 slightly hypointense on
T2-weighted images.

25. UVEAL METASTASES:
 Through posterior
ciliary arteries.
 Commonly involve the
posterior half of the
globe.
 primary lesions
common sources of
uveal metastases are
breast and lung
carcinoma.

26. UVEAL METASTASES:
 Both eyes are affected
in about one-third of
cases.
 Also may involve
extraocular muscles.
 MR imaging is superior
to CT.
 Signals similar to
Amelanotic
melanomas.

27. UVEAL METASTASES:
 Homogenous
enhancing criteria.

28. THANKS.