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Imaging evaluation of fetal vascular anomalies

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Abstract

Vascular anomalies can be detected in utero and should be considered in the setting of solid, mixed or cystic lesions in the fetus. Evaluation of the gray-scale and color Doppler US and MRI characteristics can guide diagnosis. We present a case-based pictorial essay to illustrate the prenatal imaging characteristics in 11 pregnancies with vascular malformations (5 lymphatic malformations, 2 Klippel-Trenaunay syndrome, 1 venous-lymphatic malformation, 1 Parkes-Weber syndrome) and vascular tumors (1 congenital hemangioma, 1 kaposiform hemangioendothelioma). Concordance between prenatal and postnatal diagnoses is analyzed, with further discussion regarding potential pitfalls in identification.

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References

  1. Navarro OM, Laffan EE, Ngan BY (2009) Pediatric soft-tissue tumors and pseudo-tumors: MR imaging features with pathologic correlation: part 1. Imaging approach, pseudotumors, vascular lesions, and adipocytic tumors. Radiographics 29:887–906

    Article  PubMed  Google Scholar 

  2. Mulliken JB, Glowacki J (1982) Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 69:412–422

    Article  CAS  PubMed  Google Scholar 

  3. Kollipara R, Dinneen L, Rentas KE et al (2013) Current classification and terminology of pediatric vascular anomalies. AJR Am J Roentgenol 201:1124–1135

    Article  PubMed  Google Scholar 

  4. International Society for the Study of Vascular Anomalies (2014) ISSVA classification updates. http://www.issva.org/content.aspx?page_id=22&club_id=298433&module_id=152904

  5. Fishman SJ, Mulliken JB (1993) Hemangiomas and vascular malformations of infancy and childhood. Pediatr Clin N Am 40:1177–1200

    CAS  Google Scholar 

  6. Behr GG, Johnson C (2013) Vascular anomalies: hemangiomas and beyond — part 1, fast-flow lesions. AJR Am J Roentgenol 200:414–422

    Article  PubMed  Google Scholar 

  7. Behr GG, Johnson CM (2013) Vascular anomalies: hemangiomas and beyond — part 2, slow-flow lesions. AJR Am J Roentgenol 200:423–436

    Article  PubMed  Google Scholar 

  8. Biesecker LG, Happle R, Mulliken JB et al (1999) Proteus syndrome: diagnostic criteria, differential diagnosis, and patient evaluation. Am J Med Genet 84:389–395

    Article  CAS  PubMed  Google Scholar 

  9. Marler JJ, Fishman SJ, Upton J et al (2002) Prenatal diagnosis of vascular anomalies. J Pediatr Surg 37:318–326

    Article  PubMed  Google Scholar 

  10. Hassanein AH, Mulliken JB, Fishman SJ et al (2011) Evaluation of terminology for vascular anomalies in current literature. Plast Reconstr Surg 127:347–351

    Article  CAS  PubMed  Google Scholar 

  11. Awadh AM, Prefumo F, Bland JM et al (2006) Assessment of the intraobserver variability in the measurement of fetal cardiothoracic ratio using ellipse and diameter methods. Ultrasound Obstet Gynecol 28:53–56

    Article  CAS  PubMed  Google Scholar 

  12. Kenny JF, Plappert T, Doubilet P et al (1986) Changes in intracardiac blood flow velocities and right and left ventricular stroke volumes with gestational age in the normal human fetus: a prospective Doppler echocardiographic study. Circulation 74:1208–1216

    Article  CAS  PubMed  Google Scholar 

  13. Mielke G, Benda N (2001) Cardiac output and central distribution of blood flow in the human fetus. Circulation 103:1662–1668

    Article  CAS  PubMed  Google Scholar 

  14. Mejides AA, Adra AM, O’Sullivan MJ et al (1995) Prenatal diagnosis and therapy for a fetal hepatic vascular malformation. Obstet Gynecol 85:850–853

    Article  CAS  PubMed  Google Scholar 

  15. Eivazi B, Fasunla AJ, Hundt W et al (2011) Low flow vascular malformations of the head and neck: a study on brightness mode, color coded duplex and spectral Doppler sonography. Eur Arch Otorhinolaryngol 268:1505–1511

    Article  PubMed  Google Scholar 

  16. Goncalves LF, Rojas MV, Vitorello D et al (2000) Klippel-Trenaunay-Weber syndrome presenting as massive lymphangiohemangioma of the thigh: prenatal diagnosis. Ultrasound Obstet Gynecol 15:537–541

    Article  CAS  PubMed  Google Scholar 

  17. Rasidaki M, Sifakis S, Vardaki E et al (2005) Prenatal diagnosis of a fetal chest wall cystic lymphangioma using ultrasonography and MRI: a case report with literature review. Fetal Diagn Ther 20:504–507

    Article  PubMed  Google Scholar 

  18. Moukaddam H, Pollak J, Haims AH (2009) MRI characteristics and classification of peripheral vascular malformations and tumors. Skelet Radiol 38:535–547

    Article  Google Scholar 

  19. Robson CD, Barnewolt CE (2004) MR imaging of fetal head and neck anomalies. Neuroimaging Clin N Am 14:273–291

    Article  PubMed  Google Scholar 

  20. Kathary N, Bulas DI, Newman KD et al (2001) MRI imaging of fetal neck masses with airway compromise: utility in delivery planning. Pediatr Radiol 31:727–731

    Article  CAS  PubMed  Google Scholar 

  21. Papetti L, Tarani L, Nicita F et al (2012) Macrocephaly-capillary malformation syndrome: description of a case and review of clinical diagnostic criteria. Brain Dev 34:143–147

    Article  PubMed  Google Scholar 

  22. Vurucu S, Battal B, Kocaoglu M et al (2009) Klippel-Trenaunay syndrome with hemimegalencephaly, retroperitoneal lymphangioma and double inferior vena cava. Br J Radiol 82:e102–e104

    Article  CAS  PubMed  Google Scholar 

  23. Alvarez RM, Garcia-Diaz L, Marquez J et al (2011) Hemimegalencephaly: prenatal diagnosis and outcome. Fetal Diagn Ther 30:234–238

    Article  PubMed  Google Scholar 

  24. Marler JJ, Mulliken JB (2005) Current management of hemangiomas and vascular malformations. Clin Plast Surg 32:99–116

    Article  PubMed  Google Scholar 

  25. Sherer DM, Perenyi AR, Glick SA et al (2006) Prenatal sonographic findings of extensive low-flow mixed lymphatic and venous malformations. J Ultrasound Med 25:1469–1473

    PubMed  Google Scholar 

  26. Elia D, Garel C, Enjolras O et al (2008) Prenatal imaging findings in rapidly involuting congenital hemangioma of the skull. Ultrasound Obstet Gynecol 31:572–575

    Article  CAS  PubMed  Google Scholar 

  27. Kaplan MC, Coleman BG, Shaylor SD et al (2013) Sonographic features of rare posterior fetal neck masses of vascular origin. J Ultrasound Med 32:873–880

    Article  PubMed  Google Scholar 

  28. Croteau SE, Liang MG, Kozakewich HP et al (2013) Kaposiform hemangioendothelioma: atypical features and risks of Kasabach-Merritt phenomenon in 107 referrals. J Pediatr 162:142–147

    Article  PubMed Central  PubMed  Google Scholar 

  29. Boon LM, Fishman SJ, Lund DP et al (1995) Congenital fibrosarcoma masquerading as congenital hemangioma: report of two cases. J Pediatr Surg 30:1378–1381

    Article  CAS  PubMed  Google Scholar 

  30. Kubota A, Imano M, Yonekura T et al (1999) Infantile myofibromatosis of the triceps detected by prenatal sonography. J Clin Ultrasound 27:147–150

    Article  CAS  PubMed  Google Scholar 

  31. Ziyeh S, Spreer J, Rossler J et al (2004) Parkes Weber or Klippel-Trenaunay syndrome? Non-invasive diagnosis with MR projection angiography. Eur Radiol 14:2025–2029

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, MLC 5031 Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229-3039, USA

    Maria A. Calvo-Garcia, Beth M. Kline-Fath, Bernadette L. Koch & Tal Laor

  2. Department of Pediatrics and Hemangioma and Vascular Malformation Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Denise M. Adams

  3. Department of Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Anita Gupta

  4. Pediatric Surgery and Fetal Center of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Foong-Yen Lim

Authors
  1. Maria A. Calvo-Garcia
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  2. Beth M. Kline-Fath
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  3. Denise M. Adams
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  4. Anita Gupta
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  5. Bernadette L. Koch
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  6. Foong-Yen Lim
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  7. Tal Laor
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Correspondence to Maria A. Calvo-Garcia.

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Calvo-Garcia, M.A., Kline-Fath, B.M., Adams, D.M. et al. Imaging evaluation of fetal vascular anomalies. Pediatr Radiol 45, 1218–1229 (2015). https://doi.org/10.1007/s00247-014-3248-x

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  • DOI: https://doi.org/10.1007/s00247-014-3248-x

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