link
Bookmarks
Vascular Anomaly
Esther H. Y. Hung, MBChB, FRCR, FHKCR, FHKAM (Radiology); James F. Griffith, MD, MRCP, FRCR
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
0
6
1
5

KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Definitions

          • "Vascular anomaly" comprises both vascular tumors & vascular malformation
            • Differentiation based on cellular turnover, histology, natural history, imaging, & physical findings
          • Vascular tumors
            • Features cellular proliferation & hyperplasia
            • Classified as benign (most common), locally aggressive, or borderline & malignant
            • Benign: Infantile hemangioma, congenital hemangioma, pyogenic granuloma (lobular capillary hemangioma)
              • Infantile hemangioma = most common childhood vascular tumor
                • Grows after birth with early proliferative stage & later involuntary stage
            • Local aggressive: Tufted angioma, kaposiform hemangioendothelioma
            • Malignant: Angiosarcoma
          • Vascular malformation
            • Vascular dysplasia rather than actual tumor
              • Dysplastic vascular channels with normal endothelial turnover
            • Present at birth & grows commensurately with child without proliferation or involution
            • Subdivided into simple, combined, involving major vessel ± associated with other anomalies
              • Simple type is based on predominant vessel type affected, e.g., capillary, venous, arteriovenous, or lymphatic
                • Venous malformation = most common vascular malformation
              • Combined type: Arteriovenous fistula, capillary/venous, lymphatic/venous, etc.
            • Will be low flow or high flow depending on color Doppler flow dynamics
              • Low-flow vascular malformations: Venous, capillary, lymphatic, or capillary/venous
              • High-flow vascular malformations: Arteriovenous malformation, arteriovenous fistula

        IMAGING

        • General Features

          • Radiographic Findings

            • MR Findings

              • Ultrasonographic Findings

                • Angiographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Johnson CM et al: Clinical and sonographic features of pediatric soft-tissue vascular anomalies part 1: classification, sonographic approach and vascular tumors. Pediatr Radiol. 47(9):1184-1195, 2017
                                      2. Johnson CM et al: Clinical and sonographic features of pediatric soft-tissue vascular anomalies part 2: vascular malformations. Pediatr Radiol. 47(9):1196-1208, 2017
                                      Related Anatomy
                                      Loading...
                                      Related Differential Diagnoses
                                      Loading...
                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Definitions

                                              • "Vascular anomaly" comprises both vascular tumors & vascular malformation
                                                • Differentiation based on cellular turnover, histology, natural history, imaging, & physical findings
                                              • Vascular tumors
                                                • Features cellular proliferation & hyperplasia
                                                • Classified as benign (most common), locally aggressive, or borderline & malignant
                                                • Benign: Infantile hemangioma, congenital hemangioma, pyogenic granuloma (lobular capillary hemangioma)
                                                  • Infantile hemangioma = most common childhood vascular tumor
                                                    • Grows after birth with early proliferative stage & later involuntary stage
                                                • Local aggressive: Tufted angioma, kaposiform hemangioendothelioma
                                                • Malignant: Angiosarcoma
                                              • Vascular malformation
                                                • Vascular dysplasia rather than actual tumor
                                                  • Dysplastic vascular channels with normal endothelial turnover
                                                • Present at birth & grows commensurately with child without proliferation or involution
                                                • Subdivided into simple, combined, involving major vessel ± associated with other anomalies
                                                  • Simple type is based on predominant vessel type affected, e.g., capillary, venous, arteriovenous, or lymphatic
                                                    • Venous malformation = most common vascular malformation
                                                  • Combined type: Arteriovenous fistula, capillary/venous, lymphatic/venous, etc.
                                                • Will be low flow or high flow depending on color Doppler flow dynamics
                                                  • Low-flow vascular malformations: Venous, capillary, lymphatic, or capillary/venous
                                                  • High-flow vascular malformations: Arteriovenous malformation, arteriovenous fistula

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • MR Findings

                                                  • Ultrasonographic Findings

                                                    • Angiographic Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Microscopic Features

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Demographics

                                                                  • Natural History & Prognosis

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Johnson CM et al: Clinical and sonographic features of pediatric soft-tissue vascular anomalies part 1: classification, sonographic approach and vascular tumors. Pediatr Radiol. 47(9):1184-1195, 2017
                                                                          2. Johnson CM et al: Clinical and sonographic features of pediatric soft-tissue vascular anomalies part 2: vascular malformations. Pediatr Radiol. 47(9):1196-1208, 2017