Vascular anomalies | Clinical features | MR imaging features* | Treatment |
---|---|---|---|
Vascular tumors | |||
 Infantile hemangioma | Proliferating phase: occurs in 1st few weeks of life; rapidly growing lesion; strawberry-like, pulsatile, warm mass | Proliferating phase: well-defined lobulated mass, low SI on T1WI, high SI on T2WI, flow voids on SE images, no perilesion edema, early homogeneous enhancement | None (propranolol) |
 | Involuting phase: grayish dark red mass; complete regression at age 7–10 y | Involuting phase: fat replacement (high SI on T1WI), decreased enhancement |  |
Low-flow vascular malformations | |||
 Venous | Occurs in childhood or early adulthood; blue, soft, compressible, non-pulsatile mass; grows proportionally with the child without regression | Septated lobulated mass without mass effect, phleboliths (low SI), fluid–fluid levels, low SI on T1WI, high SI on T2WI, no flow voids on SE images, infiltrates tissue planes, surrounding edema possible, no arterial or early venous enhancement, slow gradual enhancement, diffuse enhancement on delayed images | Percutaneous sclerotherapy |
 Lymphatic | Occurs in childhood; smooth, noncompressible, rubbery mass; grows proportionally with the child without regression | Septated lobulated mass, fluid–fluid levels, low SI on T1WI, high SI on T2WI, no flow voids on SE images, infiltrates tissue planes; if macrocystic, has rim and septal enhancement; if microcystic, no significant or slight diffuse enhancement | Percutaneous sclerotherapy |
 Capillary | Occurs at birth; cutaneous red discoloration; grows proportionally with the child without regression | Skin-thickness lesion | None |
High-flow vascular malformations | |||
 AVM | Occurs in childhood or early adulthood; red, pulsatile, warm mass with a thrill; grows proportionally with the child without regression | No well-defined mass; enlarged feeding arteries and draining veins; flow voids on SE images; infiltrates tissue planes; early enhancement of enlarged feeding arteries and nidus with shunting to draining veins | Transarterial embolization |