Estudios de imagen en el diagnóstico de los hemangiomas y malformaciones vasculares

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Abstract

El diagnóstico de los hemangiomas y malformaciones vasculares cutáneas se basa en la historia clínica y la exploración física. Los estudios de imagen pueden ser necesarios para esclarecer y confirmar el diagnóstico, y para analizar la extensión de las lesiones al permitir evaluar el componente no visible de las mismas así como la afectación de estructuras vecinas. Por último, también juegan un papel importante a la hora de planificar y dirigir el tratamiento, bien sea quirúrgico o endovascular. Las técnicas de imagen empleadas para los hemangiomas y malformaciones vasculares incluyen: la radiología simple, la ecografía (Doppler), la tomografía computarizada (angio TC), la resonancia magnética (angio RM), y la técnicas angiográficas (arteriografía, flebografía).

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Most cited references 34

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Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics.

J Mulliken, J Glowacki (1982)

Forty-nine specimens from a variety of vascular lesions were analyzed for cellular characteristics. Two major categories of lesions emerged from this investigation: hemangiomas and vascular malformations. This classification and its implications are justified by several considerations. Hemangiomas in the proliferating phase (n = 14) were distinguished by (1) endothelial hyperplasia with incorporation of [3H]thymidine, (2) multilaminated basement membrane formation beneath the endothelium, and (3) clinical history of rapid growth during early infancy. Hemangiomas in the involuting phase (n = 12) exhibited (1) histologic fibrosis and fat deposition, (2) low to absent [3H]thymidine labeling of endothelial cells, and (3) rapid growth and subsequent regression. The endothelium in hemangiomas had many characteristics of differentiation: Weibel-Palade bodies, alkaline phosphatase, and factor VIII production. Vascular malformations (n = 23) demonstrated no tritiated thymidine incorporation and normal ultrastructural characteristics. These lesions were usually noted at birth, grew proportionately with the child, and consisted of abnormal, often combined, capillary, arterial, venous, and lymphatic vascular elements. This cell-oriented analysis provides a simple yet comprehensive classification of vascular lesions of infancy and childhood and serves as a guide for diagnosis, management, and further research.

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Childhood hemangiomas and vascular malformations: angiographic differentiation.

Michael Strand, J Mulliken, John P. Burrows … (1983)

Clinical and cellular differences between hemangiomas and vascular malformations in children have been defined. Hemangiomas are benign endothelial cell neoplasms that appear in infancy and usually have a natural history of proliferation and involution. Vascular malformations are errors of vascular morphogenesis that are present at birth, grow with the child, and never involute but often expand. The authors reviewed the preoperative angiograms of 14 children who had cellular analyses of resected vascular lesions. Hemangiomas could be distinguished from vascular malformations by the presence of a well circumscribed mass demonstrating intense tissue staining, usually organized in a lobular pattern. The vascular malformations, although angiographically variable depending on the predominant vascular channel type, were diffuse lesions consisting entirely of vessels without intervening tissue stain. These angiographic differences between hemangiomas and vascular malformations corroborate clinical and laboratory studies.

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Lymphangioma of the retroperitoneum: CT and sonographic characteristic.

Lance A. Davidson, D Hartman (1990)

The authors retrospectively evaluated radiologic, clinical, and pathologic findings in 19 cases of lymphangioma of the retroperitoneum. The tumors were judged confined to one compartment of the retroperitoneum in 68% of the cases, whereas in 32% of cases the tumor involved more than one compartment. Abdominal radiography depicted the mass in all cases. Excretory urography demonstrated organ displacement without tumor invasion in all cases. Sonography showed multiloculated fluid in 61% of cases and a unicameral mass in 39% of cases. All but one of the multiloculated lymphangiomas had thick septa. Sonography also depicted the fluid as uncomplicated in 56% of cases. The remainder had debris that sometimes layered in the dependent portion of the cyst. Computed tomography (CT) showed a unicameral mass in 57% and a septated mass in 43% of cases. CT also showed thin, smooth walls in 79% and thick, irregular walls in 21% of cases. At CT the fluid contents were found to be homogeneous and of fluid attenuation in 64% and were complex in 36% of cases. The attenuation of fluid in one case was the same as that of retroperitoneal fat. In two cases the mass contained mural calcification. The most characteristic radiologic finding of lymphangioma of the retroperitoneum is an elongated tumor containing uncomplicated fluid with or without septa. Chyle and mural calcification are very uncommon in this location.

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SciELO Spain ID:: S1137-66272004000200007

DOI:: 10.4321/s1137-66272004000200007

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http://creativecommons.org/licenses/by/4.0/

ScienceOpen disciplines: Public health

Keywords: Haemangioma,Vascular malformation,Diagnosis,Hemangioma,Malformación vascular,Diagnóstico

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ScienceOpen disciplines: Public health

Keywords: Haemangioma, Vascular malformation, Diagnosis, Hemangioma, Malformación vascular, Diagnóstico

Estudios de imagen en el diagnóstico de los hemangiomas y malformaciones vasculares

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Abstract

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SciELO Spain

Most cited references 34

Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics.

Childhood hemangiomas and vascular malformations: angiographic differentiation.

Lymphangioma of the retroperitoneum: CT and sonographic characteristic.

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