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MRI features of bilateral parotid haemangiomas of infancy
Savvas Andronikou1, Kieran McHugh, Saaleeha Jadwat
1Department of Radiology, Red Cross Children's Hospital, Institute of Child Health and University of Cape Town, Klipfontein Road, Rondebosch, 7700, Cape Town, South Africa. docsav@mweb.co.za
Abstract:
The aim of this article is to report the MRI features of bilateral parotid haemangiomas of infancy and highlight the diagnostic and prognostic value of MRI especially with regard to those lesions that may cause respiratory compromise. Retrospective review of MRI scans in six infants with bilateral parotid haemangiomas. The bilateral haemangiomas were symmetrical in all but one patient. On T1-weighted images the masses were isointense to muscle and on T2 they were hyperintense with numerous small vessels giving a septated appearance. There was vivid enhancement with gadolinium in all cases. In three patients, deep bilateral extensions were demonstrated involving the parapharyngeal spaces resulting in respiratory compromise which required tracheostomy. Bilateral parotid haemangiomas are rare, but when present may have deep extensions, which can result in respiratory compromise requiring tracheostomy.
Insights
Bilateral parotid hemangiomas in infants are rare but can cause respiratory issues. MRI is crucial for diagnosing these growths and identifying deep extensions that may require intervention.
Area of Science:
- Medical Imaging
- Pediatric Radiology
- Vascular Malformations
Background:
- Bilateral parotid hemangiomas are uncommon congenital vascular tumors in infants.
- These lesions can present diagnostic challenges and pose risks of airway compromise.
Purpose of the Study:
- To describe the MRI characteristics of bilateral parotid hemangiomas in infants.
- To evaluate the diagnostic and prognostic utility of MRI in managing these lesions, particularly concerning respiratory compromise.
Main Methods:
- Retrospective review of MRI scans from six infants diagnosed with bilateral parotid hemangiomas.
- Analysis of imaging features on T1-weighted, T2-weighted, and post-contrast sequences.
Main Results:
- Hemangiomas were typically isointense on T1-weighted and hyperintense on T2-weighted MRI sequences.
- Vivid gadolinium enhancement was observed in all cases, with evidence of numerous small vessels and a septated appearance.
- Deep bilateral extensions into parapharyngeal spaces were identified in three infants, leading to respiratory compromise and the need for tracheostomy.
Conclusions:
- Bilateral parotid hemangiomas, though rare, necessitate thorough MRI evaluation due to potential for deep extensions.
- MRI plays a vital role in identifying lesions causing respiratory compromise, guiding timely intervention such as tracheostomy.
