Hong Kong Med J 2010;16:334–40 | Number 5, October 2010
An institutional review of paediatric haemangiomas: prevalence, imaging features, and outcomes
Darshana D Rasalkar, Winnie CW Chu, Frankie WT Cheng, Vincent Lee, KH Lee, CK Li
Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
OBJECTIVE. To review the demographic data, imaging features, and outcomes of paediatric haemangiomas.
DESIGN. Retrospective study.
SETTING. University teaching hospital, Hong Kong.
PATIENTS. A total of 58 children diagnosed with haemangioma between 1998 and 2007.
MAIN OUTCOME MEASURES. Demographic data, imaging features, type of treatment received, and outcomes.
RESULTS. In all, 19 (33%) of these patients were males and 39 (67%) were females. Most of the lesions (64%) were in the head and neck region. Three (5%) of the patients were complicated by the Kasabach-Merritt syndrome; 21 underwent no imaging, and 37 had ultrasound and/or magnetic resonance imaging. In the majority (85%), ultrasound of the lesions revealed mixed echogenicity and/or phleboliths with variable colour Doppler patterns. On magnetic resonance imaging, most (87%) of the lesions were T1 iso- to hypo-intense and T2 hyperintense with slight heterogeneous signalling and revealed presence of central flow voids (vascular channels) or low-signal areas (fibrous tissue or calcification). In all, 85% appeared homogeneous while 15% showed heterogeneous enhancement. Of 58 patients, 39 (67%) patients received conservative treatment; the lesions resolved spontaneously in 34 (87%) patients, enlarged in 2 (5%), and remained static in 3 (8%). Interventions were directed at the lesions in 19 patients. These entailed surgical excision (n=7), argon laser therapy (n=3), and medical treatment (n=9). Of the latter patients, treatment included: systemic steroids (n=5), interferon (n=1), steroids and interferon (n=1), vincristine (n=1), and sclerotherapy (n=1). Partial or complete resolution of the lesions ensued in 15 (79%) of the patients, while their size remained static in four (21%).
CONCLUSION. Though ultrasound and magnetic resonance imaging features varied, the diagnosis of most haemangiomas could be confidently made by imaging. About 33% of haemangiomas underwent surgical/medical interventions, for which imaging was useful to monitor post-treatment progress.
Key words: Child; Hemangioma; Magnetic resonance Imaging; Soft tissue neoplasms; Ultrasonography, Doppler, color
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