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DOI: 10.4103/ijri.IJRI_439_19
MRI evaluation of soft tissue vascular malformations
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Abstract
Background: Soft tissue vascular malformations are not uncommonly encountered in clinical practice and are often mistaken for other pathologies. Vascular anomalies are divided into vascular tumors and malformations. Vascular malformations progressively increase in size with increasing age and are classified into low-flow (venous, lymphatic, veno-lymphatic, capillary and capillary venous) and high-flow malformations (arteriovenous malformations (AVM) and arteriovenous fistula (AVF)) depending on the presence or absence of arterial flow. Aim: Aim of this study is to evaluate the Magnetic resonance imaging (MRI) features of the soft tissue vascular malformations and to classify the lesions depending on flow pattern. Materials and Methods: A total of 52 patients of soft tissue vascular malformations were included in this study over a period of 3 years. All patients underwent detailed clinical examination and dynamic post contrast MRI evaluation. Doppler and ultrasound were done as an adjunct. Results: There were 31 females and 21 male patients with age ranging from 9 to 34 years. In total 33 venous, 11 lymphatic, 8 veno-lymphatic malformations were seen. No case of high-flow malformation was seen. Majority of the lesions involved the head and neck region and the extremities. Fat saturated T2WI, STIR, and 3D dynamic post contrast sequences were found to be the most useful MRI sequences. Conclusion: MRI is the modality of choice for evaluating the soft tissue vascular malformations. It depicts the extent of the lesion, classifies the lesions into low or high flow and helps in treatment planning.
Publication History
Received: 04 November 2019
Accepted: 09 April 2020
Article published online:
19 July 2021
© 2020. 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/).
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References
- 1 Flors L, Leiva-Salinas C, Maged IM, Norton PT, Matsumoto AH, Angle JF. et al. MR imaging of soft tissue vascular malformations: Diagnosis, classification and therapy follow up. Radiographics 2011; 31: 1321-40
- 2 Navarro OM, Laffan EE, Ngan BY. Pediatric soft- tissue tumors and pseudotumors: MR imaging features with pathologic correlation. I. Imaging approach, pseudotumors, vascular lesions, and adipocytictumors. Radiographics 2009; 29: 887-906
- 3 Paltiel HJ, Burrows PE, Kozakewich HP, Zura-kowski D, Mulliken JB. Soft-tissue vascular anomalies: Utility of US for diagnosis. Radiology 2000; 214: 747-54
- 4 Enjolras O. Classification and management of the various superficial vascular anomalies: Hemangiomas and vascular malformations. J Dermatol 1997; 24: 701-10
- 5 Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: A classification based on endothelial characteristics. Plast Reconstr Surg 1982; 69: 412-22
- 6 Jackson IT, Carreño R, Potparic Z, Hussain K. Hemangiomas, vascular malformations, and lymphovenous malformations: Classification and methods of treatment. Plast Reconstr Surg 1993; 91: 1216-30
- 7 Herborn CU, Goyen M, Lauenstein TC, Debatin JF, Ruehm SG, Kröger K. Comprehensive time- resolved MRI of peripheral vascular malformations. AJR Am J Roentgenol 2003; 181: 729-35
- 8 Rak KM, Yakes WF, Ray RL, Dreisbach JN, Parker SH, Luethke JM. et al. MR imaging of symptomatic peripheral vascular malformations. AJR Am J Roentgenol 1992; 159: 107-12
- 9 Donnelly LF, Adams DM, Bisset 3rd GS. Vascular malformations and hemangiomas: A practical approach in a multidisciplinary clinic. AJR Am J Roentgenol 2000; 174: 597-608
- 10 Siegel MJ. Magnetic resonance imaging of musculoskeletal soft tissue masses. RadiolClin North Am 2001; 39: 701-20
- 11 Flors L, Leiva-Salinas C, Norton PT, Park AW, Ogur T, Hagspiel KD. Tenfrequently asked questions about MRI evaluation of soft tissue vascular malformations. AJR 2013; 201: W554-62
- 12 Dubois J, Soulez G, Oliva VL, Berthiaume MJ, Lapierre C, Therasse E. Soft-tissue venous malformations in adult patients: Imaging and therapeutic issues. Radiographics 2001; 21: 1519-31
- 13 Abernethy LJ. Classification and imaging of vascular malformations in children. Eur Radiol 2003; 13: 2483-97
- 14 Fayad LM, Hazirolan T, Bluemke D, Mitchell S. Vascular malformations in the extremities: Emphasis on MR imaging features that guide treatment options. Skeletal Radiol 2006; 35: 127-37
- 15 Konez O, Burrows PE, Mulliken JB, Fishman SJ, Kozakewich HP. Angiographic features of rapidly involuting congenital hemangioma (RICH). Pediatr Radiol 2003; 33: 15-9
- 16 Breugem CC, Maas M, van der Horst CM. Magnetic resonance imaging findings of vascular malformations of the lower extremity. Plast Reconstr Surg 2001; 108: 878-84
- 17 Richter GT, Friedman AB. Hemangiomas and vascular malformations: Current theory and management. Int J Pediatr 2012; 645678: 1-10
- 18 Ernemann U, Kramer U, Miller S, Bisdas S, Rebmann H, Breuninger H. et al. Current concepts in classification, diagnosis and treatment of vascular anomalies. Eur J Radiol 2010; 75: 2-11