Sclerotherapy with intralesional bleomycin injection under guidance of multi-slice CT for retrobulbar orbital low-flow vascular lesions-single-center experience

Br J Radiol. 2024 Jan 23;97(1153):186-194. doi: 10.1093/bjr/tqad008.

Abstract

Objective: This study investigated the safety and efficacy of sclerotherapy with intralesional bleomycin injection (IBI) for retrobulbar orbital low-flow vascular lesions under multi-slice computed tomography (CT) guidance.

Methods: Between January 2010 and September 2021, consecutive patients with retrobulbar orbital low-flow vascular lesions who underwent CT-guided IBI at a tertiary centre in Taiwan were enrolled. Their medical records and imaging data were retrospectively collected.

Results: This study enrolled 13 patients (7 male and 6 female patients; age range: 1-57 years; mean age: 25.9 years) with lymphatic malformation (LM, n = 4), venolymphatic malformation (n = 1), and venous malformation (VM, n = 8). The overall radiological response rate was 76.9% (10 of 13); the radiological response rate was 75.0% in the VM group (6 of 8) and 75.0% in the LM group (3 of 4). Moreover, 3 patients (23.1%) had minor complications and 1 (7.7%) had a major complication. The mean clinical and radiological follow-up was 8.3 months and no recurrence or progression was reported.

Conclusion: CT-guided IBI is an effective and relatively safe minimally invasive treatment for retrobulbar orbital low-flow vascular lesions, with an overall radiological response rate of 76.9% in a mean of 1.5 sessions and a low complication rate.

Advances in knowledge: CT-guided sclerotherapy with IBI is a relatively safe, effective, and feasible alternative treatment option for retrobulbar orbital low-flow vascular lesions.

Keywords: Bleomycin; Multidetector Computed Tomography; Orbital disease; Radiography, Interventional; Vascular malformations.

MeSH terms

  • Adolescent
  • Adult
  • Bleomycin*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Injections, Intralesional
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sclerotherapy*
  • Tomography, X-Ray Computed
  • Young Adult

Substances

  • Bleomycin