CTA and CTV Area of Interest With IV Contrast CTA and CTV of the upper extremity was shown by Henzler et al [44] to be the superior imaging modality compared with MRI and US because it provides images with high spatial resolution for excellent delineation of the anatomy and extent of VTs and VMs, providing a vascular map of the lesion for use in treatment planning. Soft Tissue Vascular Anomalies-Child CTA of the chest, using a modified pulmonary CTA and CTV protocol, is used to optimally show the feeding artery, nidus, and draining vein components of the PAVM [42]. CTA and CTV may provide further anatomic definition of a VM after US in other anatomies, aiding in visualizing phleboliths, thrombus, osseous changes such as erosion or findings related to overgrowth syndromes, and soft tissue involvement, especially in defining the deep or infiltrative extent of a VA [39-41,45]. MRA and MRV Area of Interest Without and With IV Contrast MRA of the area of interest without and with IV contrast may be used to define venous and arterial anatomy, as well as better differentiate the tissue types involved in the VM. MRA and MRV of the area of interest without IV contrast, using flow-dependent or flow-independent techniques, can be used as well. For example, Relaxation- Enhanced Angiography without Contrast and Triggering, a flow-independent T2-weighted noncontrast-enhanced MRA sequence, has been shown to be effective for defining the anatomy of major feeding arteries and draining veins and correlation with contrast-enhanced MRA and MRV [32,46]. Contrast-enhanced 3-D and 4-D dynamic MRA acquisitions are helpful in distinguishing whether flow through the lesion is slow or fast, arterial and venous anatomy, the location of a nidus in an AVM, and the site of vascular fistula in an AVF.
Soft Tissue Vascular Anomalies Vascular Malformations and Infantile Vascular Tumors Non CNS Child. CTA and CTV Area of Interest With IV Contrast CTA and CTV of the upper extremity was shown by Henzler et al [44] to be the superior imaging modality compared with MRI and US because it provides images with high spatial resolution for excellent delineation of the anatomy and extent of VTs and VMs, providing a vascular map of the lesion for use in treatment planning. Soft Tissue Vascular Anomalies-Child CTA of the chest, using a modified pulmonary CTA and CTV protocol, is used to optimally show the feeding artery, nidus, and draining vein components of the PAVM [42]. CTA and CTV may provide further anatomic definition of a VM after US in other anatomies, aiding in visualizing phleboliths, thrombus, osseous changes such as erosion or findings related to overgrowth syndromes, and soft tissue involvement, especially in defining the deep or infiltrative extent of a VA [39-41,45]. MRA and MRV Area of Interest Without and With IV Contrast MRA of the area of interest without and with IV contrast may be used to define venous and arterial anatomy, as well as better differentiate the tissue types involved in the VM. MRA and MRV of the area of interest without IV contrast, using flow-dependent or flow-independent techniques, can be used as well. For example, Relaxation- Enhanced Angiography without Contrast and Triggering, a flow-independent T2-weighted noncontrast-enhanced MRA sequence, has been shown to be effective for defining the anatomy of major feeding arteries and draining veins and correlation with contrast-enhanced MRA and MRV [32,46]. Contrast-enhanced 3-D and 4-D dynamic MRA acquisitions are helpful in distinguishing whether flow through the lesion is slow or fast, arterial and venous anatomy, the location of a nidus in an AVM, and the site of vascular fistula in an AVF.