PDF herunterladen
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2024; 34(01): 103-127
DOI: 10.1055/s-0043-1774391
Review Article

Pediatric Vascular Anomalies: A Clinical and Radiological Perspective

Rahul Gupta 
1   Department of Paediatric Surgery, SMS Medical College, JLN Marg, Jaipur, Rajasthan, India
,
Anu Bhandari
2   Department of Radiodiagnosis, SMS Medical College, JLN Marg, Jaipur, Rajasthan, India
,
Oscar M. Navarro 
3   Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Toronto, ON, Canada
4   Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
› Institutsangaben Funding None.
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

According to the International Society for the Study of Vascular Anomalies (ISSVA) classification, vascular anomalies include a diverse range of pathologies, classified as either vascular tumors or vascular malformations. This classification, last revised in 2018, aims to explain the biological basis of vascular lesions and help clinicians to manage the anomalies. In vascular tumors, there are proliferative changes of endothelial cells, while vascular malformations primarily consist of structural vascular abnormalities. Infantile hemangioma is the most common soft-tissue vascular tumor. Vascular malformations are an extensive group of malformations of the arterial, venous, and lymphatic systems, either in isolation or in combination. Radiological evaluation plays a key part in the management of pediatric patients with these entities. The understanding of sonography and magnetic resonance imaging findings entails its correlation with clinical findings at the time of scanning.

Keywords

congenital hemangioma - infantile hemangioma - pediatric - vascular anomalies - vascular malformations

Author Contributions

R.G. conceived and designed the study. All the authors contributed in the drafting of the article. All the authors collected, organized, analyzed, and interpreted the data. O.N. and A.B. provided critical revision and wrote the final draft of the article. All the authors critically reviewed and approved the final draft and are responsible for the content and similarity index of the manuscript.


Ethical Approval and Informed Consent

International and local guidelines regarding ethical principles were followed during the conduction of research and preparation of the manuscript.


Informed written consent was taken from the participants for use of their photographs and radiological images in the study.




Publikationsverlauf

Artikel online veröffentlicht:
16. September 2023

© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Sadick M, Müller-Wille R, Wildgruber M, Wohlgemuth WA. Vascular anomalies (Part I): classification and diagnostics of vascular anomalies. Röfo Fortschr Geb Röntgenstr Neuen Bildgeb Verfahr 2018; 190 (09) 825-835
    Thieme ConnectPubMedSuche in Google Scholar
  • 2 Wassef M, Borsik M, Cerceau P. et al. Classification of vascular tumours and vascular malformations. Contribution of the ISSVA 2014/2018 classification. Ann Pathol 2021; 41 (01) 58-70
    CrossrefPubMedSuche in Google Scholar
  • 3 Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 1982; 69 (03) 412-422
    CrossrefPubMedSuche in Google Scholar
  • 4 Shatzkes DR. Vascular anomalies: description, classification and nomenclature. Appl Radiol 2018; 47 (09) 8-13
    Suche in Google Scholar
  • 5 International Society for the Study of Vascular Anomalies. ISSVA Classification of Vascular Anomalies. 2018. Accessed March 15, 2022 at: issva.org/classification
  • 6 Gibson CR, Barnacle AM. Vascular anomalies: special considerations in children. CVIR Endovasc 2020; 3 (01) 60
    CrossrefPubMedSuche in Google Scholar
  • 7 Johnson CM, Navarro OM. Clinical and sonographic features of pediatric soft-tissue vascular anomalies part 2: vascular malformations. Pediatr Radiol 2017; 47 (09) 1196-1208
    CrossrefPubMedSuche in Google Scholar
  • 8 Kunimoto K, Yamamoto Y, Jinnin M. ISSVA classification of vascular anomalies and molecular biology. Int J Mol Sci 2022; 23 (04) 2358
    CrossrefPubMedSuche in Google Scholar
  • 9 Vaidya S, Cooke D, Kogut M, Stratil PG, Bittles MA, Sidhu M. Imaging and percutaneous treatment of vascular anomalies. Semin Intervent Radiol 2008; 25 (03) 216-233
    Thieme ConnectPubMedSuche in Google Scholar
  • 10 Johnson CM, Navarro OM. Clinical and sonographic features of pediatric soft-tissue vascular anomalies part 1: classification, sonographic approach and vascular tumors. Pediatr Radiol 2017; 47 (09) 1184-1195
    CrossrefPubMedSuche in Google Scholar
  • 11 Merrow AC, Gupta A, Patel MN, Adams DM. Revised classification of vascular lesions from the International Society for the Study of Vascular Anomalies: radiologic–pathologic update. Radiographics 2016; 36 (05) 1494-1516
    CrossrefPubMedSuche in Google Scholar
  • 12 Krol A, MacArthur CJ. Congenital hemangiomas: rapidly involuting and noninvoluting congenital hemangiomas. Arch Facial Plast Surg 2005; 7 (05) 307-311
    CrossrefPubMedSuche in Google Scholar
  • 13 Smith CJF, Friedlander SF, Guma M, Kavanaugh A, Chambers CD. Infantile hemangiomas: an updated review on risk factors, pathogenesis, and treatment. Birth Defects Res 2017; 109 (11) 809-815
    CrossrefPubMedSuche in Google Scholar
  • 14 Padhiyar JK, Patel NH, Gajjar TP, Buch MD, Shah YB, Solanki R. Efficacy and safety of propranolol on the proliferative phase of infantile hemangioma: a hospital-based prospective study. Indian J Dermatol 2018; 19: 224-229
    CrossrefSuche in Google Scholar
  • 15 Brandling-Bennett HA, Metry DW, Baselga E. et al. Infantile hemangiomas with unusually prolonged growth phase: a case series. Arch Dermatol 2008; 144 (12) 1632-1637
    CrossrefPubMedSuche in Google Scholar
  • 16 Léauté-Labrèze C, Harper JI, Hoeger PH. Infantile haemangioma. Lancet 2017; 390 (10089): 85-94
    CrossrefPubMedSuche in Google Scholar
  • 17 Liang MG, Frieden IJ. Infantile and congenital hemangiomas. Semin Pediatr Surg 2014; 23 (04) 162-167
    CrossrefPubMedSuche in Google Scholar
  • 18 Dubois J, Patriquin HB, Garel L. et al. Soft-tissue hemangiomas in infants and children: diagnosis using Doppler sonography. Am J Roentgenol 1998; 171 (01) 247-252
    CrossrefPubMedSuche in Google Scholar
  • 19 Metry DW, Haggstrom AN, Drolet BA. et al. A prospective study of PHACE syndrome in infantile hemangiomas: demographic features, clinical findings, and complications. Am J Med Genet A 2006; 140 (09) 975-986
    CrossrefPubMedSuche in Google Scholar
  • 20 Haggstrom AN, Garzon MC, Baselga E. et al. Risk for PHACE syndrome in infants with large facial hemangiomas. Pediatrics 2010; 126 (02) e418-e426
    CrossrefPubMedSuche in Google Scholar
  • 21 Metry D, Heyer G, Hess C. et al; PHACE Syndrome Research Conference. Consensus statement on diagnostic criteria for PHACE syndrome. Pediatrics 2009; 124 (05) 1447-1456
    CrossrefPubMedSuche in Google Scholar
  • 22 Rotter A, Samorano LP, Rivitti-Machado MC, Oliveira ZNP, Gontijo B. PHACE syndrome: clinical manifestations, diagnostic criteria, and management. An Bras Dermatol 2018; 93 (03) 405-411
    CrossrefPubMedSuche in Google Scholar
  • 23 Iacobas I, Burrows PE, Frieden IJ. et al. LUMBAR: association between cutaneous infantile hemangiomas of the lower body and regional congenital anomalies. J Pediatr 2010; 157 (05) 795-801.e1 , 7
    CrossrefPubMedSuche in Google Scholar
  • 24 Girard C, Bigorre M, Guillot B, Bessis D. Pelvis syndrome. Arch Dermatol 2006; 142 (07) 884-888
    CrossrefPubMedSuche in Google Scholar
  • 25 Stockman A, Boralevi F, Taïeb A, Léauté-Labrèze C. SACRAL syndrome: spinal dysraphism, anogenital, cutaneous, renal and urologic anomalies, associated with an angioma of lumbosacral localization. Dermatology 2007; 214 (01) 40-45
    CrossrefPubMedSuche in Google Scholar
  • 26 Hsi Dickie B, Fishman SJ, Azizkhan RG. Hepatic vascular tumors. Semin Pediatr Surg 2014; 23 (04) 168-172
    CrossrefPubMedSuche in Google Scholar
  • 27 Ji Y, Chen S, Wang Q. et al. Intolerable side effects during propranolol therapy for infantile hemangioma: frequency, risk factors and management. Sci Rep 2018; 8 (01) 4264
    CrossrefPubMedSuche in Google Scholar
  • 28 Martin K, Blei F, Chamlin SL. et al. Propranolol treatment of infantile hemangiomas: anticipatory guidance for parents and caretakers. Pediatr Dermatol 2013; 30 (01) 155-159
    CrossrefPubMedSuche in Google Scholar
  • 29 Frieden IJ, Eichenfield LF, Esterly NB, Geronemus R, Mallory SB. American Academy of Dermatology Guidelines/Outcomes Committee. Guidelines of care for hemangiomas of infancy. J Am Acad Dermatol 1997; 37 (04) 631-637
    CrossrefPubMedSuche in Google Scholar
  • 30 Kono T, Sakurai H, Groff WF. et al. Comparison study of a traditional pulsed dye laser versus a long-pulsed dye laser in the treatment of early childhood hemangiomas. Lasers Surg Med 2006; 38 (02) 112-115
    CrossrefPubMedSuche in Google Scholar
  • 31 Léauté-Labrèze C, Dumas de la Roque E, Hubiche T, Boralevi F, Thambo JB, Taïeb A. Propranolol for severe hemangiomas of infancy. N Engl J Med 2008; 358 (24) 2649-2651
    CrossrefPubMedSuche in Google Scholar
  • 32 Oranje AP, Janmohamed SR, Madern GC, de Laat PC. Treatment of small superficial haemangioma with timolol 0.5% ophthalmic solution: a series of 20 cases. Dermatology 2011; 223 (04) 330-334
    CrossrefPubMedSuche in Google Scholar
  • 33 Wu HW, Wang X, Zhang L, Zheng JW, Liu C, Wang YA. Topical timolol vs. oral propranolol for the treatment of superficial infantile hemangiomas. Front Oncol 2018; 8: 605
    CrossrefPubMedSuche in Google Scholar
  • 34 Bennett ML, Fleischer Jr AB, Chamlin SL, Frieden IJ. Oral corticosteroid use is effective for cutaneous hemangiomas: an evidence-based evaluation. Arch Dermatol 2001; 137 (09) 1208-1213
    CrossrefPubMedSuche in Google Scholar
  • 35 Haggstrom AN, Beaumont JL, Lai JS. et al. Measuring the severity of infantile hemangiomas: instrument development and reliability. Arch Dermatol 2012; 148 (02) 197-202
    CrossrefPubMedSuche in Google Scholar
  • 36 Janmohamed SR, de Waard-van der Spek FB, Madern GC, de Laat PC, Hop WC, Oranje AP. Scoring the proliferative activity of haemangioma of infancy: the Haemangioma Activity Score (HAS). Clin Exp Dermatol 2011; 36 (07) 715-723
    CrossrefPubMedSuche in Google Scholar
  • 37 Weitz NA, Lauren CT, Starc TJ. et al. Congenital cutaneous hemangioma causing cardiac failure: a case report and review of the literature. Pediatr Dermatol 2013; 30 (06) e180-e190
    CrossrefPubMedSuche in Google Scholar
  • 38 Berenguer B, Mulliken JB, Enjolras O. et al. Rapidly involuting congenital hemangioma: clinical and histopathologic features. Pediatr Dev Pathol 2003; 6 (06) 495-510
    CrossrefPubMedSuche in Google Scholar
  • 39 Martines F, Immordino V. Arteriovenous malformation of the base of tongue in pregnancy: case report. Acta Otorhinolaryngol Ital 2009; 29 (05) 274-278
    PubMedSuche in Google Scholar
  • 40 Khera PS, Garg PK, Babu S, Elhence P, Tiwari S, Nk S. Fibro adipose vascular anomaly: a rare and often misdiagnosed entity. Indian J Radiol Imaging 2021; 31 (03) 776-781
    Thieme ConnectPubMedSuche in Google Scholar
  • 41 Ji Y, Li K, Xiao X, Zheng S, Xu T, Chen S. Effects of propranolol on the proliferation and apoptosis of hemangioma-derived endothelial cells. J Pediatr Surg 2012; 47 (12) 2216-2223
    CrossrefPubMedSuche in Google Scholar
  • 42 Abreu MC, Pinto J, Rocha G. et al. Arteriovenous malformations in the neonatal period: case report and literature review. J Pediatr Neonat Individual Med 2020; 9 (01) e090126
    Suche in Google Scholar
  • 43 Dasgupta R, Patel M. Venous malformations. Semin Pediatr Surg 2014; 23 (04) 198-202
    CrossrefPubMedSuche in Google Scholar
  • 44 Soblet J, Limaye N, Uebelhoer M, Boon LM, Vikkula M. Variable somatic TIE2 mutations in half of sporadic venous malformations. Mol Syndromol 2013; 4 (04) 179-183
    CrossrefPubMedSuche in Google Scholar
  • 45 Legiehn GM, Heran MK. A step-by-step practical approach to imaging diagnosis and interventional radiologic therapy in vascular malformations. Semin Intervent Radiol 2010; 27 (02) 209-231
    Thieme ConnectPubMedSuche in Google Scholar
  • 46 Trop I, Dubois J, Guibaud L. et al. Soft-tissue venous malformations in pediatric and young adult patients: diagnosis with Doppler US. Radiology 1999; 212 (03) 841-845
    CrossrefPubMedSuche in Google Scholar
  • 47 Paltiel HJ, Burrows PE, Kozakewich HP, Zurakowski D, Mulliken JB. Soft-tissue vascular anomalies: utility of US for diagnosis. Radiology 2000; 214 (03) 747-754
    CrossrefPubMedSuche in Google Scholar
  • 48 Lowe LH, Marchant TC, Rivard DC, Scherbel AJ. Vascular malformations: classification and terminology the radiologist needs to know. Semin Roentgenol 2012; 47 (02) 106-117
    CrossrefPubMedSuche in Google Scholar
  • 49 Legiehn GM, Heran MK. Classification, diagnosis, and interventional radiologic management of vascular malformations. Orthop Clin North Am 2006; 37 (03) 435-474 , vii–viii
    CrossrefPubMedSuche in Google Scholar
  • 50 Nguyen HL, Boon LM, Vikkula M. Genetics of vascular malformations. Semin Pediatr Surg 2014; 23 (04) 221-226
    CrossrefPubMedSuche in Google Scholar
  • 51 Comi AM. Sturge-Weber syndrome. Handb Clin Neurol 2015; 132: 157-168
    CrossrefPubMedSuche in Google Scholar
  • 52 Elluru RG, Balakrishnan K, Padua HM. Lymphatic malformations: diagnosis and management. Semin Pediatr Surg 2014; 23 (04) 178-185
    CrossrefPubMedSuche in Google Scholar
  • 53 de Serres LM, Sie KC, Richardson MA. Lymphatic malformations of the head and neck. A proposal for staging. Arch Otolaryngol Head Neck Surg 1995; 121 (05) 577-582
    CrossrefPubMedSuche in Google Scholar
  • 54 Hawkins CM, Chewning RH. Diagnosis and management of extracranial vascular malformations in children: arteriovenous malformations, venous malformations and lymphatic malformations. Semin Roentgenol 2019; 54 (04) 337-348
    CrossrefPubMedSuche in Google Scholar
  • 55 Chaudry G, Guevara CJ, Rialon KL. et al. Safety and efficacy of bleomycin sclerotherapy for microcystic lymphatic malformation. Cardiovasc Intervent Radiol 2014; 37 (06) 1476-1481
    CrossrefPubMedSuche in Google Scholar
  • 56 Wu C, Song D, Guo L, Wang L. Refractory head and neck lymphatic malformation in infants treated with sirolimus: a case series. Front Oncol 2021; 11: 616702
    CrossrefPubMedSuche in Google Scholar
  • 57 Uller W, Alomari AI, Richter GT. Arteriovenous malformations. Semin Pediatr Surg 2014; 23 (04) 203-207
    CrossrefPubMedSuche in Google Scholar
  • 58 Garzon MC, Huang JT, Enjolras O, Frieden IJ. Vascular malformations: part I. J Am Acad Dermatol 2007; 56 (03) 353-370 , quiz 371–374
    CrossrefPubMedSuche in Google Scholar
  • 59 Lam K, Pillai A, Reddick M. Peripheral arteriovenous malformations: classification and endovascular treatment. Appl Radiol 2017; 46 (05) 15-21
    CrossrefSuche in Google Scholar
  • 60 Uller W, Fishman SJ, Alomari AI. Overgrowth syndromes with complex vascular anomalies. Semin Pediatr Surg 2014; 23 (04) 208-215
    CrossrefPubMedSuche in Google Scholar
  • 61 Kang H-C, Baek ST, Song S, Gleeson JG. Clinical and genetic aspects of the segmental overgrowth spectrum due to somatic mutations in PIK3CA. J Pediatr 2015; 167 (05) 957-962
    CrossrefPubMedSuche in Google Scholar
  • 62 John PR. Klippel-Trenaunay syndrome. Tech Vasc Interv Radiol 2019; 22 (04) 100634
    CrossrefPubMedSuche in Google Scholar
  • 63 Martinez-Lopez A, Blasco-Morente G, Perez-Lopez I. et al. CLOVES syndrome: review of a PIK3CA-related overgrowth spectrum (PROS). Clin Genet 2017; 91 (01) 14-21
    CrossrefPubMedSuche in Google Scholar
  • 64 Al-Huniti A, Fantauzzi M, Willis L, Sadlier M, Amaral JG, Carcao MD. Sirolimus leads to rapid improvement in fibroadipose vascular anomalies: experience in 11 children. J Vasc Anomalies (Phila) 2021; 2 (04) e030
    CrossrefSuche in Google Scholar
  • 65 Revencu N, Boon LM, Mendola A. et al. RASA1 mutations and associated phenotypes in 68 families with capillary malformation-arteriovenous malformation. Hum Mutat 2013; 34 (12) 1632-1641
    CrossrefPubMedSuche in Google Scholar
  • 66 Kurek KC, Howard E, Tennant LB. et al. PTEN hamartoma of soft tissue: a distinctive lesion in PTEN syndromes. Am J Surg Pathol 2012; 36 (05) 671-687
    CrossrefPubMedSuche in Google Scholar
  • 67 Dasgupta R, Fishman SJ. Management of visceral vascular anomalies. Semin Pediatr Surg 2014; 23 (04) 216-220
    CrossrefPubMedSuche in Google Scholar
  • 68 Chaudry G, Burrows PE, Padua HM, Dillon BJ, Fishman SJ, Alomari AI. Sclerotherapy of abdominal lymphatic malformations with doxycycline. J Vasc Interv Radiol 2011; 22 (10) 1431-1435
    CrossrefPubMedSuche in Google Scholar
  • 69 Wassef M, Blei F, Adams D. et al; ISSVA Board and Scientific Committee. Vascular anomalies classification: recommendations from the International Society for the Study of Vascular Anomalies. Pediatrics 2015; 136 (01) e203-e214
    CrossrefPubMedSuche in Google Scholar