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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleHead and NeckF
Open Access

Contrast-Enhancement of the Anterior Eye Segment in Patients with Retinoblastoma: Correlation between Clinical, MR Imaging, and Histopathologic Findings

P. de Graaf, P. van der Valk, A.C. Moll, S.M. Imhof, A.Y.N. Schouten-van Meeteren, D.L. Knol and J.A. Castelijns
American Journal of Neuroradiology February 2010, 31 (2) 237-245; DOI: https://doi.org/10.3174/ajnr.A1825
P. de Graaf
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P. van der Valk
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A.C. Moll
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S.M. Imhof
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A.Y.N. Schouten-van Meeteren
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D.L. Knol
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J.A. Castelijns
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Abstract

BACKGROUND AND PURPOSE: AES contrast-enhancement is recognized in a substantial number of retinoblastoma-affected eyes. We retrospectively investigated the histopathologic basis of AES contrast-enhancement on MR images in retinoblastoma.

MATERIALS AND METHODS: Pretreatment contrast-enhanced MR images were obtained from 42 children with retinoblastoma. Forty-two enucleated eyes were included in this study, AES enhancement was evaluated by using a 3-point score, and these data were correlated with clinical, MR imaging, and histopathologic findings. Additionally, 14 specimens were immunohistochemically analyzed for CD31, VEGF, and Flt-1 expression. Statistical correlations with AES enhancement were assessed by using a linear-by-linear association test and univariate and multivariate ordinal regressions.

RESULTS: The degree of abnormal AES enhancement was moderate in 15 (36%) eyes and strong in 14 (33%) eyes, whereas 13 (31%) eyes showed normal AES enhancement. In multivariate analysis, the degree of AES enhancement showed statistically significant correlations with iris surface-vessel count (P = .05) and optic nerve invasion (P = .04) in the enucleated eye and with tumor volume (P = .02) as detected on MR imaging. No significant associations between AES enhancement and VEGF expression in the iris were observed. Flt-1 (P = .04) staining in iris stroma and IA as detected with CD31 staining (P = .009) both yielded a statistically significant positive correlation with abnormal AES enhancement.

CONCLUSIONS: The degree of abnormal AES enhancement on MR imaging in retinoblastoma reflects angiogenesis in the iris. AES enhancement is also a hallmark of advanced retinoblastoma because its degree correlates with tumor volume and optic nerve invasion.

Abbreviations

AC
anterior chamber
AES
anterior eye segment
BOB
blood-ocular barrier
C
cornea
MVD
microvessel density
Flt-1
VEGF-receptor-1
H&E
hematoxylin-eosin
HIF-1
hypoxia-inducible factor
HPF
high-power field
IA
iris angiogenesis
IOP
intraocular pressure
VEGF
vascular endothelial growth factor
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American Journal of Neuroradiology: 31 (2)
American Journal of Neuroradiology
Vol. 31, Issue 2
1 Feb 2010
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Cite this article
P. de Graaf, P. van der Valk, A.C. Moll, S.M. Imhof, A.Y.N. Schouten-van Meeteren, D.L. Knol, J.A. Castelijns
Contrast-Enhancement of the Anterior Eye Segment in Patients with Retinoblastoma: Correlation between Clinical, MR Imaging, and Histopathologic Findings
American Journal of Neuroradiology Feb 2010, 31 (2) 237-245; DOI: 10.3174/ajnr.A1825

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Contrast-Enhancement of the Anterior Eye Segment in Patients with Retinoblastoma: Correlation between Clinical, MR Imaging, and Histopathologic Findings
P. de Graaf, P. van der Valk, A.C. Moll, S.M. Imhof, A.Y.N. Schouten-van Meeteren, D.L. Knol, J.A. Castelijns
American Journal of Neuroradiology Feb 2010, 31 (2) 237-245; DOI: 10.3174/ajnr.A1825
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