View 2019 Abstracts

Functional epiphora is a common and poorly understood condition. Dacryocystogram and dacryscintigraphy are variably used to investigate it but have major limitations with physiological and anatomical information respectively. We describe the use of dynamic magnetic resonance dacryocystography (MRDCG) to provide functional video images of the lacrimal drainage system.

15 volunteers with no lacrimal symptoms and 5 patients with unilateral epiphora were prospectively recruited and underwent dynamic MRDCG. Dotarem contrast agent (Gadoteric acid 0.5 mmol/mL) was diluted 50 folds in sterile normal saline and infused from an Alaris GH Syringe Pump machine (infusion rate of 3mls/h) through a cannula onto the patient’s eyes. The volumetric interpolated breath-hold examination (VIBE) sequence was used to visualise contrast flow through the lacrimal drainage system on a 1.5T MRI scanner.

Dynamic MRDCG with VIBE provides videos that reliably demonstrate contrast flow that is physiological and gives good anatomical data.

Dynamic MRDCG provides good structural and temporal resolution of tear flow. It has the potential to be used as a routine clinical investigation of patients with epiphora that can safely and quickly provide functional and anatomical information of the tear drainage system and surrounding region. This may help understand the cause and guide the treatment of lacrimal drainage disease.