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Published on: October 20, 2017
Cervicofacial venous malformations. MRI features and interventional strategies
O Konez1, P E Burrows, J B Mulliken
1Department of Radiology, Children's Hospital, Harvard Medical School, Boston, MA, USA.
Summary
This study highlights that advanced MRI techniques, including post-contrast and gradient-echo imaging, are crucial for diagnosing cervicofacial venous malformations. Sclerotherapy remains a primary treatment, often requiring diverse strategies for optimal patient outcomes.
Area of Science:
- Vascular Malformations
- Radiology
- Interventional Therapy
Background:
- Cervicofacial venous malformations present diagnostic challenges.
- Standard MRI sequences may not fully characterize these lesions.
- Sclerotherapy is a common treatment modality.
Purpose of the Study:
- To evaluate the diagnostic utility of comprehensive MRI in cervicofacial venous malformations.
- To analyze demographic data and therapeutic strategies in patients with these malformations.
- To identify associated conditions like Sinus Pericranii and Blue Rubber Bleb Nevus Syndrome.
Main Methods:
- Retrospective analysis of 53 patients with cervicofacial venous malformations.
- Review of demographic data, MRI findings, and interventional strategies.
- Detailed examination of MRI characteristics including T1, T2, post-contrast, and gradient-echo sequences.
Main Results:
- Characteristic MRI findings include space-occupying lesions with hyperintense T2 signals, patchy enhancement, and absent flow on gradient echo.
- Sinus pericranii (SP) identified in 11% of patients.
- Blue Rubber Bleb Nevus Syndrome (BRBNS) identified in 4% of patients.
Conclusions:
- Complete MRI work-up necessitates post-contrast and gradient-echo imaging alongside standard sequences.
- Diverse therapeutic strategies, beyond common sclerosants like sodium tetradecyl or ethanol, are often required.
- Most venous anomalies were sporadic.
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