scholarly journals THE IMPORTANCE OF ACCURATE IMAGING DIAGNOSIS OF A VASCULAR ANOMALY PRIOR TO THE SURGICAL PROCEDURE

2021 ◽  
Vol 68 (2) ◽  
pp. 301-305
Author(s):  
Maria Popescu ◽  
◽  
Gabriel Drăgan ◽  
Alina Oprescu ◽  
◽  
...  

The diagnosis of vascular tumors and malformations is usually achieved with clinical history and physical examination. The imaging of these patients has been sufficiently refined to answer pertinent questions when trying to make an accurate differential diagnosis in order to establish an informed treatment plan. The imaging modalities at hand include ultrasound, doppler sonography, magnetic resonance imaging and contrast material enhanced magnetic resonance angiography. We present two cases of different vascular anomalies that were managed according to the clinical aspect, natural history and imaging performed. Moreover, with better understanding of the imaging features, the radiologist has become a key player in the diagnosis and management plan of the vascular anomalies. This is crucial in avoiding misdiagnosis and improper treatment.

Author(s):  
Maliha Sadick ◽  
Daniel Overhoff ◽  
Bettina Baessler ◽  
Naema von Spangenberg ◽  
Lena Krebs ◽  
...  

Background Peripheral vascular anomalies represent a rare disease with an underlying congenital mesenchymal and angiogenetic disorder. Vascular anomalies are subdivided into vascular tumors and vascular malformations. Both entities include characteristic features and flow dynamics. Symptoms can occur in infancy and adulthood. Vascular anomalies may be accompanied by characteristic clinical findings which facilitate disease classification. The role of periinterventional imaging is to confirm the clinically suspected diagnosis, taking into account the extent and location of the vascular anomaly for the purpose of treatment planning. Method In accordance with the International Society for the Study of Vascular Anomalies (ISSVA), vascular anomalies are mainly categorized as slow-flow and fast-flow lesions. Based on the diagnosis and flow dynamics of the vascular anomaly, the recommended periinterventional imaging is described, ranging from ultrasonography and plain radiography to dedicated ultrafast CT and MRI protocols, percutaneous phlebography and transcatheter angiography. Each vascular anomaly requires dedicated imaging. Differentiation between slow-flow and fast-flow vascular anomalies facilitates selection of the appropriate imaging modality or a combination of diagnostic tools. Results Slow-flow congenital vascular anomalies mainly include venous and lymphatic or combined malformations. Ultrasound and MRI and especially MR-venography are essential for periinterventional imaging. Arteriovenous malformations are fast-flow vascular anomalies. They should be imaged with dedicated MR protocols, especially when extensive. CT with 4D perfusion imaging as well as time-resolved 3D MR-A allow multiplanar perfusion-based assessment of the multiple arterial inflow and venous drainage vessels of arterio-venous malformations. These imaging tools should be subject to intervention planning, as they can reduce procedure time significantly. Fast-flow vascular tumors like hemangiomas should be worked up with ultrasound, including color-coded duplex sonography, MRI and transcatheter angiography in case of a therapeutic approach. In combined malformation syndromes, radiological imaging has to be adapted according to the dominant underlying vessels and their flow dynamics. Conclusion Guide to evaluation of flow dynamics in peripheral vascular anomalies, involving vascular malformations and vascular tumors with the intention to facilitate selection of periinterventional imaging modalities and diagnostic and therapeutic approach to vascular anomalies. Key Points:  Citation Format


2020 ◽  
Vol VOLUME 8 (ISSUE 1) ◽  
pp. 1-8
Author(s):  
Arulalan Mathialagan

Abstract Background- Head and neck vascular anomalies are a spectrum of lesion ranging from simple asymptomatic malformations to life-threatening airway vascular tumors. Management of these lesion poses a real challenge to even most experienced otolaryngologists.Systematic evaluation and prompt diagnosis and judicial choice of treatment are essential for proper management of these lesions. Material and methods-A retrospective review of the head and neck vascular anomalies over three years, from 2017 to 2019 in a tertiary referral centre. Clinical features, radiology, treatment and follow-up data were studied.We did a literature review to give a comprehensive analysis regarding the diagnosis and treatment of the vascular anomalies of the head and neck region. Results- A total of 25 patients were managed in our department in two years. Of these 25 patients, three patients had infantile haemangioma(12%), six patient had congenital haemangioma(24%), six patients had lymphatic malformation(24%), four patient had an arteriovenous malformation (16%), and six patient had venous malformation (24%). Sixpatients (24%) underwent surgery as treatment, which includes one case of noninvoluting congenital hemangioma (NICH) of the temporal bone, one facial AVM, twolateral neck lymphangiomas, one skull base lymphangioma and a venous neck malformation. All the infantile h a ema n gi oma s we rema n a g e d w i t h o ra l propranolol, three lymphatic malformations underwent sclerotherapy, while the three Arteriovenous malformations (AVM), 􀃶ve congenital haemangiomas and four Venous malformations (VM) were under observation. Conclusion-Managing a vascular anomaly requires a prompt diagnosis based on the ISSVA classi􀃶cation, patients' symptoms and the location of the lesion. Not all vascular anomaly requires active management. Careful case selection and a multidisciplinary team are essential for adequate management of the vascular anomalies. Key Words: Vascular Malformation, Hemangioma, Lymphangioma


Author(s):  
Kristy Pahl ◽  
Waleska Pabon-Ramos ◽  
Michael Jeng

Vascular anomalies are a group of disorders divided into two distinct subtypes: vascular tumors and vascular malformations. Vascular tumors are proliferative in nature, while malformations are non-proliferative. Simple, localized vascular malformations refer to a group of malformations that are localized to a single area of involvement. These simple malformations include capillary, lymphatic, venous, and arteriovenous malformations. The pediatric hematologist and oncologist is becoming increasingly involved in the diagnosis and management of these disorders. This review presents four cases as a means to discuss the diagnosis, clinical and imaging features, and management strategies of simple, localized vascular malformations.


VASA ◽  
2015 ◽  
Vol 44 (2) ◽  
pp. 92-105 ◽  
Author(s):  
Robert K. Clemens ◽  
Thomas Pfammatter ◽  
Thomas O. Meier ◽  
Ahmad I. Alomari ◽  
Beatrice R. Amann-Vesti

The correct diagnosis of vascular malformations is obtainable by clinical assessment and patient history in the majority of cases. Nonetheless, confusion in nomenclature, existence of multiple classifications and rarity of these lesions leads to misdiagnosis and related wrong treatment. This is especially the case in combined or complex vascular malformations or vascular malformations that are part of syndromes as these have overlapping clinical and imaging features. New entities in the field of vascular anomalies have been described recently like fibro-adipose vascular anomaly or central conducting lymphatic anomalies.


2021 ◽  
Vol 64 (9) ◽  
pp. 614-621
Author(s):  
Joon Seok Lee ◽  
Ho Yun Chung

Background: In the 1980s, vascular anomalies were divided into two major subgroups—vascular tumors and vascular malformations—based on the functional framework. This concept has been fundamental to the management of vascular anomalies and expanded and refined by the International Society for the Study of Vascular Anomalies. Vascular malformations are further sub-divided into several types; however, there are many cases with insufficient information about the disease.Current Concepts: Several instances have shown that the diagnosis of vascular malformations can be achieved after a careful evaluation of patient history and examination. However, recently developed imaging technology has been of great help in the diagnosis. Doppler ultrasonography, magnetic resonance imaging, computed tomography scan, and angiography are valuable tools for diagnostic and therapeutic planning. Advanced diagnostic and therapeutic technologies have also provided more accurate and safer diagnoses and appropriate treatment. Recently, an improved method of managing vascular malformations has emerged, based on a multidisciplinary approach, which is very useful for increasing the treatment efficacy. The development of gene research has enabled the investigation of disease-related genes and the development of new medications.Discussion and Conclusion: Accurate diagnosis of vascular malformations is one of the most crucial factors in determining treatment plan and prognosis, based on which it would be possible to achieve effective results through appropriate management and a multidisciplinary team approach.


2021 ◽  
pp. 12-17
Author(s):  
R. I. Khabarova ◽  
S. A. Kulyova ◽  
S. V. Ivanova ◽  
S. N. Novikov ◽  
E. D. Gumbatova ◽  
...  

The Kasabach–Merritt phenomenon is a rare thrombocytopenic consumption of coagulopathy that occurs against the background of such vascular anomalies as kaposiform hemangioendothelioma and giant angioma. Timely diagnosis and treatment of Kasabach–Merritt syndrome which includes therapy for vascular tumors and life‑threatening conditions are critical in resolving this rare vascular anomaly. The aim of the study is to analyze radiation therapy as salvage therapy for kaposiform hemangioendothelioma and giant angioma associated with the Kasabach–Merritt phenomenon.


2012 ◽  
Vol 12 (5) ◽  
pp. 331-339 ◽  
Author(s):  
Melania Costantini ◽  
Paolo Belli ◽  
Daniela Distefano ◽  
Enida Bufi ◽  
Marialuisa Di Matteo ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhehao Lyu ◽  
Lili Liu ◽  
Huimin Li ◽  
Haibo Wang ◽  
Qi Liu ◽  
...  

Abstract Background Collecting (Bellini) duct carcinoma (CDC) is a highly malignant and rare kidney tumor. We report our 12-year experience with CDC and the results of a retrospective analysis of patients and tumor characteristics, clinical manifestations, and imaging features by computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT. Methods Retrospective examination of tumors between January 2007 and December 2019 identified 13 cases of CDC from three medical centers in northern China. All 13 patients underwent CT scan, among which eight underwent dynamic enhanced CT scan, two underwent PET/CT scan, and one underwent magnetic resonance cholangiopancreatography (MRCP) examination. The lesions were divided into nephritis type and mass type according to the morphology of the tumors. Results The study group included ten men and three women with an average age of 64.23 ± 10.74 years. The clinical manifestations were gross hematuria, flank pain, and waist discomfort. The mean tumor size was 8.48 ± 2.48 cm. Of the 13 cases, six (46.2%) were cortical-medullary involved type and seven (53.8%) were cortex–medullary–pelvis involved type. Eleven (84.6%) cases were nephritis type and two (15.4%) were mass type. The lesions appeared solid or complex solid and cystic on CT and MRI. The parenchymal area of the tumors showed isodensity or slightly higher density on unenhanced CT scan in the 13 cases. PET/CT in two cases showed increased radioactivity intake. Evidence of intra-abdominal metastatic disease was present on CT in nine (69.2%) cases. Conclusions The imaging characteristics of CDC differ from those of other renal cell carcinomas. In renal tumors located in the junction zone of the renal cortex and medulla that show unclear borders, slight enhancement, and metastases in the early stage, a diagnosis of CDC needs to be considered. PET/CT provides crucial information for the diagnosis of CDC, as well as for designing treatment strategies including surgery.


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