Head and Neck Vascular Anomalies in the Pediatric Population

Vascular lesions of the pediatric orbit: A radiological walkthrough

“…Their appearance can be preceded by a “premonitory cutaneous mark” that looks like a pale spot, telangiectatic or macular red stain, or a bruise-like pseudo-ecchymotic patch ( 12 ). During infancy, IHs undergo a rapid growth (phase 1, proliferative) followed by a prolonged period of spontaneous involution (phase 2, involuting) that can last years, during which the lesion is replaced by fat and fibrotic tissue; by late childhood, they have generally involuted completely (phase 3, involuted) ( 13 ). IHs are also further divided according to their anatomical configuration into focal, multifocal, segmental and indeterminate ( 14 ).…”

“…CMs are superficial, therefore their imaging findings - when present - are often subtle and not specific: on US, they are usually isoechoic and confined to the dermis, showing occasionally Doppler flow ( 34 ). On MRI they may appear as subtle signal intensity abnormalities within the cutaneous or subcutaneous tissues or simply as skin thickening ( 13 ) that can enhance after contrast administration ( Figures 7 , 8 ). If imaging is of limited usefulness in their diagnosis, however it does play a major role in ruling out the presence of associated deeper vascular anomalies when a syndromic association is suspected – SWS being by far the most common.…”

“…While most children with facial capillary malformations do not have Sturge-Weber syndrome, the overall risk of the syndrome in children with vascular malformations of the face - especially those following frontonasal placode - is approximately 8% ( 52 ). Due to the severity of the disease, all neonates with facial capillary malformations involving the forehead, eyelids and parietal region or frontonasal area should undergo contrast-enhanced MRI to evaluate leptomeningeal capillary and venular malformations ( 13 ) ( Figure 7 ).…”

“…The spectral Doppler analysis shows arterial vessels with high-velocity flow and low resistive index ( 64 ). MRI and CT angiography are ideal noninvasive modalities for visualizing the entire course and extent of an AVM, to assess organ involvement and for planning endovascular or surgical management ( 13 ). MRI is the finest technique to estimate the expansion of the malformation and its rapports with adjacent structures ( 69 ).…”