Tips and tricks to optimize MRI protocols for cutaneous vascular anomalies

Mamlouk, Mark D.; Nicholson, Andrew; Cooke, Daniel L; Hess, Christopher P.

doi:10.1016/j.clinimag.2017.05.019

Cited by 20 publications

(9 citation statements)

References 24 publications

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“…MRI produces high resolution images of deep subcutaneous structures with specific highlighting of layers of fat-containing (T1-weighted) and water-containing (T2-weighted) content (10, 35–37). Relatively little resolution of the epidermis and dermis is seen (10), although ultrasensitive radiofrequency detectors can provide additional resolution to more superficial structures (38).…”

Section: Resultsmentioning

confidence: 99%

“…Given its relatively high cost and time consumption compared to ultrasound, it is rarely utilized in dermatologic practice and research (13). The utility of MRI in dermatology is in the assessment of deep involvement of subcutaneous, fascial and muscular structures in inflammatory disorders such as morphea and sclerodermoid disorders (35), as well as in management of patients with inherited disorders such as neurofibromatosis (36) and vascular and lymphatic malformations (37).…”

Section: Resultsmentioning

confidence: 99%

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A Scoping Review of Non-invasive Imaging Modalities in Dermatological Disease: Potential Novel Biomarkers in Hidradenitis Suppurativa

2019

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Background: The development of imaging-based biomarkers has the potential to overcome major challenges in the accurate and reproducible assessment of disease severity and response to novel therapies in Hidradenitis Suppurativa (HS). Understanding the advantages and limitations of existing non-invasive imaging modalities in dermatological disease will aid in the development of hypotheses and inform the design of future studies.Methods: A scoping review was performed using Medline, Embase, Web of Science Databases and evaluation of “gray literature” until June 30, 2019. Citations were examined according to pre-defined inclusion and exclusion criteria. Citations were reviewed by two independent reviewers. Narrative Synthesis was used to summarize data, structured by imaging modality.Results: Non-invasive imaging modalities, such as ultrasound, MRI, RCM, EIS, OCT, and MIT, were identified. Only ultrasound, MRI and MIT have been used in HS. Image modalities vary in image depth, resolution, cost, accessibility and correlation with known aspects of disease activity in HS.Discussion and Conclusion: The benefits and limitations of each imaging modality are products of cost, accessibility, validity and reliability. An additional hurdle to the development of image-based biomarkers in HS is a lack of established analytical benchmarks that can be correlated with existing biological, inflammatory and clinical parameters. This review has identified potential imaging biomarkers, as well as relevant analytical benchmarks that reflect the presence or absence of disease. Further investigation work is needed to analytically and clinically validate these imaging variables in order to identify potential imaging biomarkers in HS.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Scoping Review of Non-invasive Imaging Modalities in Dermatological Disease: Potential Novel Biomarkers in Hidradenitis Suppurativa

2019

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“…Typical MRI findings (Figs. 3 and 4) included a well-defined 'mass lesion' with characteristic 'flow voids' (in T1 and T2WI) that showed avid enhancement after IV contrast injection [8,9].…”

Section: Diagnosismentioning

confidence: 99%

Infantile haemangioma: 5-year experience at the vascular anomaly clinic

AbouZeid

Ragab

Mohammad

et al. 2021

Egypt Pediatric Association Gaz

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Background Infantile haemangiomas (IH) represent a common benign vascular tumour affecting the paediatric population. Infantile haemangiomas are characterised by a natural history differentiating it from other vascular anomalies. After a transient proliferative phase in early infancy, the tumour passes through a plateau phase before going into spontaneous involution. In this report, we tried to share our experience over the last 5 years in managing cases presenting with IH at a specialised vascular anomaly clinic. Main body of abstract This report included cases of IH who were attending the vascular anomaly clinic during the period 2015 through 2019. Data of all patients attending the clinic were retrospectively examined. Files of 103 cases with IH were available for review. The diagnosis of IH was usually straight forward owing to the typical history and characteristic findings at clinical examination. A significant female predominance was noticed. Generally, IH were more common in the head and neck region (70%). Active intervention was necessary in specific situations (eye occlusion, airway involvement, large lesions with skin ulcerations). Whenever intervention proved to be necessary, propranolol was chosen as the first line of treatment with a favourable response detected in about 90% of cases. Surgery was still a valid option (6%) for lesions amenable to resection; however, we must put in consideration that most lesions will spontaneously regress. Conclusion Infantile haemangiomas are common benign vascular tumours of infancy with relatively few complications. Cosmesis is a major concern especially for lesions affecting the face. Propranolol can induce tumour regression in most cases, and generally, a favourable outcome can be anticipated.

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“…Hemangiomas are vascular tumors and show markedly hyperintense signal on ASL (Fig 2C). [12][13][14] While hemangiomas are usually well seen on postcontrast T1 imaging, particularly with the use of fat suppression, ASL could increase lesion conspicuity for improved hemangioma detection, especially if fat suppression is not used or in locations that could be overlooked such as the internal auditory canals. 22 Another advantage of ASL is its noncontrast technique.…”

Section: Conventional Mr Imaging Findingsmentioning

confidence: 99%

“…Arterial spin-labeling (ASL) is a noncontrast MR imaging perfusion sequence that has been studied in patients with stroke and vasculopathies, particularly with the Moyamoya pattern and has proved useful in analyzing CBF. 10,11 In the setting of PHACE syndrome, the concept of ASL imaging has been introduced 12,13 as well as for other cutaneous vascular anomalies. [12][13][14] The purpose of our study was to determine whether ASL perfusion can detect alterations in CBF in patients with PHACE syndrome.…”

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confidence: 99%

Arterial Spin-Labeling Perfusion for PHACE Syndrome

Mamlouk

Vossough

Caschera

et al. 2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: Arterial stroke is a rare-but-reported complication in patients with posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities (PHACE) syndrome. Currently, stroke risk is inferred by the severity of arterial anomalies identified on MRA, though no evidenced-based data exist. The purpose of our study was to determine whether arterial spin-labeling MR imaging perfusion can detect alterations in CBF in patients with PHACE syndrome. MATERIALS AND METHODS: Records were reviewed from 3 institutions for all patients with PHACE syndrome who underwent arterial spin-labeling from 2000 to 2019. CBF was qualitatively investigated with arterial spin-labeling to determine whether there was decreased or normal perfusion. Arterial anomalies were characterized on MRA imaging, and parenchymal brain findings were evaluated on conventional MR imaging sequences. RESULTS: Forty-one patients with PHACE syndrome had arterial spin-labeling imaging. There were 30 females and 11 males (age range, 7 days to 15 years). Of the 41 patients, 10 (24%) had decreased CBF signal corresponding to a major arterial territory. Ten of 10 patients had decreased CBF signal in the anterior circulation, 2/10 had decreased anterior and posterior circulation CBF signal, 2/10 had decreased bilateral anterior circulation CBF signal, and 1/10 had globally decreased CBF signal. Forty of 41 (97.5%) patients had at least 1 arteriopathy, and in those with decreased CBF signal, the arteriopathy corresponded to the CBF signal alteration in 10/10 patients. CONCLUSIONS: Arterial spin-labeling can potentially characterize hemodynamic changes in patients with PHACE syndrome. ABBREVIATIONS: ASL ¼ arterial spin-labeling; PHACE ¼ posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities A rterial ischemic stroke is a rare-but-devastating complication in a minority of patients with posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities (PHACE) syndrome. Stroke has been reported in multiple patients with PHACE syndrome, 1-6 but the etiology of stroke is poorly understood. 1 Possible mechanisms for stroke with PHACE include the following: 1) artery-to-artery embolisms, 2) ischemia from reduced blood flow, or 3) cardioembolism. These etiologies are predicated on arteriopathies in the brain, neck, and aortic arch, which are the most common extracutaneous finding in patients with PHACE syndrome. 7 In 1 study, arteriopathies were observed in 91% of 33 patients 8 and ranged from an anomalous course to marked stenosis with a Moyamoya pattern. 3 Currently, stroke risk is only inferred by the severity of these arteriopathies identified on MRA imaging. 9 Despite knowledge of the types of arteriopathies in PHACE, 3 it is unclear why certain patients with arteriopathies experience a stroke and others do not, even if there are s...

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Tips and tricks to optimize MRI protocols for cutaneous vascular anomalies

Cited by 20 publications

References 24 publications

A Scoping Review of Non-invasive Imaging Modalities in Dermatological Disease: Potential Novel Biomarkers in Hidradenitis Suppurativa

A Scoping Review of Non-invasive Imaging Modalities in Dermatological Disease: Potential Novel Biomarkers in Hidradenitis Suppurativa

Infantile haemangioma: 5-year experience at the vascular anomaly clinic

Arterial Spin-Labeling Perfusion for PHACE Syndrome

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