Imaging Spectrum of Hemangioma and Vascular Malformations of the Head and Neck in Children and Adolescents

Abstract

Vascular lesions of the head and neck region in children constitute an interesting group of lesions that benefit immensely from imaging techniques. Imaging is essential for identification, characterization, and delineation of the extent of lesion and subsequent follow-up. Infantile hemangiomas, which are vascular tumors with a specific evolution pattern, constitute a large majority of these lesions. On the other hand, there are vascular malformations, which are anomalies of the vascular system, consisting of a range of vascular tissues associated with various flow patterns. When diagnosis is clinically evident, imaging should utilize non-radiation techniques and address the issues necessary for management. Timing and interpretation of imaging methods employed in assessing childhood vascular lesion should also take into consideration the natural history so that imaging is performed to address a specific question. This review highlights the typical appearance of a hemangioma and a group of vascular malformations of the head and neck. For descriptive purpose, an attempt has been made to group lesions into specific subsites, with each one having specific clinical significance. Cases included illustrate the spectrum of the disease ranging from classical form in young children to slightly differing manifestations of the disease in adolescents and adults. The illustrations also provide a novel way of presenting image data using volume-rendering techniques of 3D data. Multi-modality team interaction and management strategies of these complex lesions are also emphasized.

Capillary Haemangioma: A Rare Vascular Tumour of the External Auditory Canal

“…CT scan provide a good assessment of the extent and bone MRI angiography the nature of the mass more definitely. However, one should bear in mind that MRI features of glomus tumours may resemble those of haemangioma [12].…”

“…The surgical approach depends on the site and extent of the lesion. Small lesions confined to the external auditory meatus can be removed following transcanal approach [12] and lesions extending to middle ear cleft and mastoid require mastoidectomy with tympanoplasty and sometimes temporal bone resection [14]. The recurrence rate is relatively high and depends on the adequacy of surgical resection.…”

Low Flow Venous Malformation Lesion Presented with Medial Canthal Swelling Simulating Swelling of the Lacrimal Sac Origin : A Case Report

“…In case of vascular malformations, ultrasonography and MRI are the techniques of choice and they are superior to computerized tomography (CT scan) for diagnosis and follow up 7 . In our patient MRI images was not conclusive to reach the final diagnosis.…”

Lumps and Bumps of the Neck in Children—Neuroimaging of Congenital and Acquired Lesions

“…Vascular malformations may remain stable, grow commensurate to the child, or demonstrate enlargement after infection, trauma, or endocrine changes (eg, puberty, pregnancy). Vascular malformations are grouped based on the predominant anomalous tissue or vessel type into lymphatic malformations, venous malformations, arteriovenous malformations (AVMs), capillary malformations, and mixed‐type lesions . The capillary malformations (previously named as port wine stain) are rather cutaneous lesions than a neck mass, therefore are beyond the scope of this review.…”

“…Anatomic MR imaging sequences demonstrate no well‐defined mass, but rather enlarged serpiginous flow voids with an additional soft tissue infiltrating component (Fig ). Evaluation of extension of the lesion and potential adjacent soft tissue and osseous involvement is important to determine …”