Biological classification of soft-tissue vascular anomalies: MR correlation.

Meyer, James S.; Hoffer, Fredric A.; Barnes, Patrick D.; Mulliken, JB

doi:10.2214/ajr.157.3.1872245

Cited by 247 publications

(101 citation statements)

References 6 publications

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“…Each arteriovenous malformation was associated with a small soft-tissue mass. We wereunableto confirmthework of Meyer et al [9], who found that arteriovenousmalfor mations can be differentiated from hemangio man by the absence of a soft-tissue mass. Only one of 70 hemangiomas showed one vessel large enough to be identified on gray-scale sonography, and no pulsatile draining veins were identified.…”

Section: Discussionsupporting

confidence: 74%

Soft-tissue hemangiomas in infants and children: diagnosis using Doppler sonography.

Dubois

Patriquin²,

Garel³

et al. 1998

American Journal of Roentgenology

214

133

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OBJECTIVE. We describethe sonographic appearanceand vascularization of hemangio mas and determine if vessel density and peak systolic Doppler shifts distinguish hemangiomas from other superficial soft-tissue masses. SUBJECTSAND METHODS. Ourpilotstudyincluded 20 infants andchildren withhemangiomas who were to undergo biopsy before treatment with interferon alpha-2b. We used Doppler sonography to determine the number of vesselsper square centimeter, peak arterial Doppler shift, resistive index, and signs of arteriovenous shunting. All hemangiomas showed high vesseldensity (more than five per squarecentimeter) and high Doppler shifts (more than 2 kHz), and these two factors became our diagnostic criteria. A prospective study of I 16 pa tients was then carried out. One hundred sixteen consecutive pediatric patients with superficial soft-tissue masses were examined using Doppler sonography: sonographic findings were compared with the final diagnoses that were established by biopsy, CT, or clinical follow-up. and a peak arterial Doppler shift exceeding 2 kHz were correctly diagnosed as hemangiomas (sensitivity, 84%; specificity, 98%). One artenovenous malformation showed high vesselden sity and high Doppler shifts, but none of the other masses that were not hemangiomas did. RESULTS. The final diagnoses included70 hemangiomas, 20 venousmalformations,Eleven patients with hemangiomas who were being treated with interferon at the time of the study fulfilled only one of the two diagnostic criteria. CONCLUSION. Highvessel density andhighpeakarterial Dopplershiftcanbeusedtodistinguish hemangiomas from other soft-tissue masses.H emangiomas,which areamongthe most common soft-tissue tumors in infants [1â€"3), typically appearas slightly raised,bluish red subcutaneousmasses that resemblethe surface of a strawberry and regressasthe child grows older. Someheman giomasdo not havethis typical appearancebe cause part or all of the lesion is deep in the soft tissue and the overlying skin appears normal.These lesions are difficult to distinguish clini cally from more suspicioussoft-tissuemasses, such as vascularmalformations, soft-tissueUi mors (e.g., metastasesfrom neuroblastomaor rhabdomyosarcoma),and infantile myofibro matosis.Children with suchlesionsareusually referredfor imaging studies or biopsy.Blood flow in superficial vessels is readily discernible using Doppler sonography. We soughtto ascertainwhetherhemangiomashave characteristic features that can be seen using high-frequency gray-scale and Doppler sonog raphy and whether they can be distinguished from other superficial soft-tissuemassesin in fantsandchildren. Subjects and Methods PilotStudyTo determine the general appearanceand vascu

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Section: Discussionsupporting

confidence: 74%

Soft-tissue hemangiomas in infants and children: diagnosis using Doppler sonography.

Dubois

Patriquin²,

Garel³

et al. 1998

American Journal of Roentgenology

214

133

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“…129 Proliferating IHs typically appear as well-defined masses with features of high flow and intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images. 130,131 Flow voids may be apparent on T2-weighted and flow-sensitive sequences, along with high-flow feeding arteries and draining veins. With administration of intravenous gadolinium, lesion enhancement is usually early, with intense and uniform enhancement on delayed images; however, diffuse or multifocal hepatic lesions may show early enhancement peripherally and delayed filling centrally (centripetal enhancement).…”

Section: Imaging Of Ihmentioning

confidence: 99%

Diagnosis and Management of Infantile Hemangioma

Darrow¹,

Mancini²,

Nopper³

et al. 2015

Pediatrics

217

290

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Infantile hemangiomas (IHs) are the most common tumors of childhood. Unlike other tumors, they have the unique ability to involute after proliferation, often leading primary care providers to assume they will resolve without intervention or consequence. Unfortunately, a subset of IHs rapidly develop complications, resulting in pain, functional impairment, or permanent disfigurement. As a result, the primary clinician has the task of determining which lesions require early consultation with a specialist. Although several recent reviews have been published, this clinical report is the first based on input from individuals representing the many specialties involved in the treatment of IH. Its purpose is to update the pediatric community regarding recent discoveries in IH pathogenesis, treatment, and clinical associations and to provide a basis for clinical decision-making in the management of IH.

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“…T 1 weighted imaging of macrocystic LMs typically shows a septated cystic mass that ranges from hypointense 37 to isointense 84 and that is often heterogeneous owing to proteinaceous fluid 85 or fluid-fluid levels. 86 Post-contrast T 1 weighted images are also important tools for differentiating macrocystic LMs from VMs, as LMs typically do not enhance after contrast injection unlike VMs (Figures 6c,d and 7). 84 By contrast, the small cystic compartments of microcystic LMs appear as diffuse hypointensity on T 1 weighted imaging and diffuse hyperintensity on T 2 weighted imaging.…”

Section: Lymphatic Malformationsmentioning

confidence: 99%

Vascular anomalies: classification, imaging characteristics and implications for interventional radiology treatment approaches

Mulligan

Prajapati²,

Martin

et al. 2014

BJR

168

132

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The term vascular anomaly represents a broad spectrum of vascular pathology, including proliferating vascular tumours and vascular malformations. While the treatment of most vascular anomalies is multifactorial, interventional radiology procedures, including embolic therapy, sclerotherapy and laser coagulation among others, are playing an increasingly important role in vascular anomaly management. This review discusses the diagnosis and treatment of common vascular malformations, with emphasis on the technique, efficacy and complications of different interventional radiology procedures.

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Biological classification of soft-tissue vascular anomalies: MR correlation.

Cited by 247 publications

References 6 publications

Soft-tissue hemangiomas in infants and children: diagnosis using Doppler sonography.

Soft-tissue hemangiomas in infants and children: diagnosis using Doppler sonography.

Diagnosis and Management of Infantile Hemangioma

Vascular anomalies: classification, imaging characteristics and implications for interventional radiology treatment approaches

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