Objectives: To describe the MR imaging features and patterns of local extension of hemangiomas of the eyelid in correlation with the clinical presentation.
Patients and methods: Retrospective study including 21 MRI (GE, 1.5T, T1 +/- Gadolinium, T2 +/- fat saturation, 3 planes) examinations performed for eyelid hemangiomas with occlusion>50% and/or ocular deviation. All examinations were reviewed by two observers using a standardized list of criteria.
Results: All hemangiomas had a heterogeneous signal described as "salt and pepper" on T2W sequences. The extension was extra-orbital in 8 cases, intra-orbital in 13 cases, extra-conal in 9 cases, intra-conal in 4 cases. The "fat sat T2" sequence provided the best anatomical details. There was a strong correlation between ocular deviation at clinical examination and intra-orbital extension, but no correlation between the extent of eyelid involvement and orbital location of the hemangioma. Dysplastic cerebellum anomalies related to the PHACES syndrome were present in 3 patients.
Conclusion: MRI of the brain and orbits provides information that appears essential for optimal management of infants with hemangioma of the eyelid.