Congenital vascular anomalies: current perspectives on diagnosis, classification, and management

Abstract

The term "congenital vascular anomalies" encompasses those vascular lesions present at birth. Many of these lesions may be detected in utero. This review serves to apprise the readership of newly identified diagnoses and updated classification schemes. Attention is focused on clinical features, patterns of presentation, clinical manifestations and behavior, diagnostic tools, and treatment modalities. It is an invigorating period for this field, with a surge in vascular anomalies-related basic and clinical research, genetics, pharmacology, clinical trials, and patient advocacy. A large number of professional conferences now include vascular anomalies in the agenda, and trainees in multiple specialties are gaining expertise in this discipline. We begin with a summary of classification schemes and introduce the updated classification adopted by the International Society for the Study of Vascular Anomalies. Disease entities are described, with liberal use of photographs, as many diagnoses can be established based on a thorough history and visual appearance and it is thus essential to develop a familiarity with diagnosisspecific physical features. Peripheral (non-central nervous system) vascular anomalies are the focus of this review. We focus on those entities in which diagnostic radiology is routinely used and accentuate when histologic confirmation is essential. We also underscore some differences in approach to the pediatric vs adolescent or adult patient. A list of Internet-based resources is included, with hyperlinks to informative sites. References are limited to seminal discoveries and review articles. We hope that our enthusiasm in writing this review will be shared by those who read this review.

Neonatal venolymphatic malformation with spontaneous parotid duct rupture: first case report

“…Nomenclature of the vascular malformations depends on the predominant type of the vessel (lymphatic, arterial or venous) [ 6 ]. Venolymphatic malformation comes under a combined category of vascular malformation [ 8 ]. Vascular malformations are also categorized according to the haemodynamic characteristics under high–low and low flow.…”

Prenatal diagnosis of vascular anomalies

“…Vascular tumors involve neoplastic proliferation of endothelial cells, while vascular malformations are developmental aberrations of hematic or lymphatic vessels. 4 Vascular malformations can further be subdivided based on the vessel involved and association with any congenital anomalies (Figure 1). The separation of vascular malformations from the tumors represented an extremely important step forward in the understanding of vascular anomalies as until this classification, every soft tissue mass that was red, purple, blue, or pink was called "hemangioma" = "benign vascular neoplasm".…”

“…Ultrasound imaging usually shows a multilocular cystic mass with thin septa (Figure 5A). On MRI, they are hypointense on T1 and hyperintense on T2 weighted images, unless complicated by internal hemorrhage or infection, which can alter the typical fluid signal characteristics 4,14 (Figures 5B and 6).…”

“…Vascular anomalies can be broadly categorized into vascular tumors and vascular malformations. Vascular tumors involve neoplastic proliferation of endothelial cells, while vascular malformations are developmental aberrations of hematic or lymphatic vessels 4 . Vascular malformations can further be subdivided based on the vessel involved and association with any congenital anomalies (Figure 1).…”

Prenatal diagnosis of congenital soft tissue hemangioma of the fetal back

“…Так по данным УЗИ на 37 неделе появился кистозный компонент. Интересно что, RICH и NICH чаще неоднородны по структуре, по сравнению с детской гемангиомой, которая, обычно, однородно эхогенна [8].…”