Imaging modalities vary in utility for diagnosing and planning treatment of orbital vascular anomalies.

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Frontiers in Medicine Published April 13, 2026 Medically reviewed April 25, 2026 DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Consider tailoring imaging modality selection to specific lesion type and clinical context for orbital vascular anomalies.

This narrative review evaluated the utility of various imaging modalities for patients presenting with a wide range of orbital vascular anomalies. The study design involved a qualitative synthesis of existing literature rather than a quantitative meta-analysis. No specific sample size or follow-up duration was reported for the review.

The review highlights that ultrasound provides dynamic assessment of vascular flow and superficial morphology, although its role is considered limited in modern practice. Computed tomography (CT) offers superior spatial resolution for osseous and calcified lesions. Magnetic resonance imaging (MRI) provides excellent soft tissue characterization and is useful for evaluating complex low-flow malformations. Angiography techniques, including MR and CT angiography, deliver detailed vascular mapping critical for pre-embolization planning, though their static nature limits the evaluation of dynamic changes. Dynamic techniques such as TRICKS MRI angiography and dynamic CT angiography enable real-time assessment of flow and venous distensibility, which may improve procedural planning.

Conventional digital subtraction angiography remains the standard for complex lesions in critical locations, combining high-temporal-resolution diagnosis with therapeutic intervention. The authors conclude that a multimodal approach is often necessary to address diagnostic, planning, and treatment needs comprehensively. No adverse events, discontinuations, or tolerability data were reported as this was a review of imaging characteristics.

Key limitations include the narrative nature of the review, which precludes meta-analysis or quantitative synthesis. There are no comparative effectiveness data, no quantitative diagnostic performance metrics, and no patient outcome data. Optimal imaging requires tailoring modality selection to lesion type and clinical context. Incorporating advanced imaging approaches may further improve diagnostic precision and outcomes, but this remains a qualitative suggestion.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedApr 2026

View Original Abstract ↓

IntroductionOrbital vascular anomalies (OVAs) encompass a heterogeneous group of lesions requiring precise imaging to guide diagnosis and treatment. Multiple imaging modalities offer distinct strengths and limitations, with the choice guided by the balance between spatial and temporal resolution. This review aligns imaging modalities with specific OVM subtypes to optimize diagnostic accuracy and procedural planning, while highlighting advanced and evolving imaging techniques that may further enhance clinical decision-making.MethodsA narrative review was conducted on studies describing imaging characteristics, diagnostic performance, and clinical utility in OVAs, supplemented with imaging from patients presenting with a wide range of lesions. All patient data were collected and reviewed in compliance with HIPAA regulations and international ethical standards.ResultsAlthough ultrasound provides dynamic assessment of vascular flow and superficial morphology, its role is limited in modern practice due to poor spatial resolution and depth penetration. CT offers superior spatial resolution for osseous and calcified lesions, while MRI provides excellent soft tissue characterization and evaluation of complex low-flow malformations. MR and CT angiography deliver detailed vascular mapping critical for pre-embolization planning, yet their static nature limits evaluation of dynamic changes. Dynamic techniques, such as Time-Resolved Imaging of Contrast KineticS (TRICKS) MRI angiography and dynamic CT angiography, enable real-time assessment of flow and venous distensibility, improving procedural planning. Conventional digital subtraction angiography remains the standard for complex lesions in critical locations, combining high-temporal-resolution diagnosis with therapeutic intervention. Given the heterogeneity of OVAs, a multimodal approach is often necessary to address diagnostic, planning, and treatment needs comprehensively.ConclusionOptimal imaging of OVAs requires tailoring modality selection to lesion type and clinical context. Incorporating advanced and emerging imaging approaches into clinical practice may further improve diagnostic precision, procedural planning, and patient outcomes.