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Ultrasonography |
1 From the Departments of Radiology (H.J.P., P.E.B.), Pathology (H.P.W.K.), and Research Computing and Biostatistics (D.Z.), and the Division of Plastic Surgery (J.B.M.), Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115. From the 1994 RSNA scientific assembly. Received February 11, 1999; revision requested April 2; revision received June 29; accepted July 20. Address reprint requests to H.J.P. (e-mail: paltiel@a1.tch.harvard.edu).
PURPOSE: To determine the ultrasonographic (US) features that distinguish soft-tissue hemangioma from vascular malformation and one type of malformation from another.
MATERIALS AND METHODS: Eighty-seven vascular anomalies were evaluated by means of US. Lesions were assessed for the presence of solid tissue and abnormal arteries, veins, or cysts. Vessel density, peak flow velocities, and resistive indexes were compared.
RESULTS: There were 49 hemangiomas and 38 vascular malformations. A significantly greater proportion of hemangiomas (48 of 49) compared with vascular malformations (zero of 38) consisted of a solid-tissue mass (P < .001). Vessel density was comparable for hemangioma and arteriovenous malformation (AVM) but significantly greater compared with the other vascular malformations (P < .001 in each case). No differences in mean arterial peak velocity were detected between hemangiomas and malformations. Mean venous peak velocity was significantly higher for AVM than for other vascular malformations and hemangioma. Mean resistive index was greater for lymphatic malformation than for hemangioma or AVM. Abnormal veins, arteries and veins, or cysts were univariate predictors for distinguishing between venous, arteriovenous, and lymphatic malformations (P < .001 in all cases). Solid-tissue mass was the only multivariate predictor for differentiating hemangioma from vascular malformation (likelihood ratio test = 109.8, P < .001).
CONCLUSION: US can be used to distinguish hemangioma from vascular malformation and detect arterial flow. These distinctions are critical for subsequent management and assessing prognosis.
Index terms: Angioma, 9*.312, 9*.83 • Arteries, abnormalities, 9*.141 • Arteriovenous malformations, 9*.14 • Lymphangioma, 9*.83 • Soft tissues, abnormalities, 9*.14 • Ultrasound (US), Doppler studies, 9*.12983 • Ultrasound (US), in infants and children, 9*.12983 • Veins, abnormalities, 9*.142
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