Risk factors for having infantile hemangiomas include prematurity, White race (3%-10%), and female sex (female:male ratio range 1.4:1 to 3:1) [15]. A rare, but important, location of infantile hemangiomas is in the airway, because rapid proliferation of the VT can obstruct the airway. Infantile hemangiomas of the airway are most commonly localized in the subglottic airway but may be more diffuse, in a beard-like distribution throughout the soft tissues overlying the mandible and neck [18]. Subglottic infantile hemangiomas may also extend from the neck into the mediastinum. Infantile hemangioma may also be associated with VAs of other organs. PHACE, an acronym for posterior fossa malformations, hemangioma, arterial anomalies, coarctation of the aorta/cardiac defects, and eye abnormalities, is predominantly a neurovascular malformation syndrome [19]. Imaging of the non-CNS lesions in PHACE syndrome, although not specifically addressed, are included in the recommendations of Variant 1. Imaging recommendations of hepatic hemangiomas found in patients with multiple cutaneous infantile hemangiomas are presented in Variant 2. Arteriography Area of Interest There is no relevant literature to support the use of arteriography of the area of interest as the initial imaging modality in infants with infantile hemangiomas. CT Area of Interest With IV Contrast When optimal imaging of the airway is required, as with hemangiomas involving the supra- or infraglottic airway or when in a beard-like distribution over the face and neck, CT with intravenous (IV) contrast may be useful. In a study of 11 children with hemangiomas of the upper airway who underwent CT, Koplewitz et al [20] found CT to have an improved definition of the airway lesion, presence, localization, and complete extent of the lesion and a more accurate size assessment compared with bronchoscopy.
Soft Tissue Vascular Anomalies Vascular Malformations and Infantile Vascular Tumors Non CNS Child. Risk factors for having infantile hemangiomas include prematurity, White race (3%-10%), and female sex (female:male ratio range 1.4:1 to 3:1) [15]. A rare, but important, location of infantile hemangiomas is in the airway, because rapid proliferation of the VT can obstruct the airway. Infantile hemangiomas of the airway are most commonly localized in the subglottic airway but may be more diffuse, in a beard-like distribution throughout the soft tissues overlying the mandible and neck [18]. Subglottic infantile hemangiomas may also extend from the neck into the mediastinum. Infantile hemangioma may also be associated with VAs of other organs. PHACE, an acronym for posterior fossa malformations, hemangioma, arterial anomalies, coarctation of the aorta/cardiac defects, and eye abnormalities, is predominantly a neurovascular malformation syndrome [19]. Imaging of the non-CNS lesions in PHACE syndrome, although not specifically addressed, are included in the recommendations of Variant 1. Imaging recommendations of hepatic hemangiomas found in patients with multiple cutaneous infantile hemangiomas are presented in Variant 2. Arteriography Area of Interest There is no relevant literature to support the use of arteriography of the area of interest as the initial imaging modality in infants with infantile hemangiomas. CT Area of Interest With IV Contrast When optimal imaging of the airway is required, as with hemangiomas involving the supra- or infraglottic airway or when in a beard-like distribution over the face and neck, CT with intravenous (IV) contrast may be useful. In a study of 11 children with hemangiomas of the upper airway who underwent CT, Koplewitz et al [20] found CT to have an improved definition of the airway lesion, presence, localization, and complete extent of the lesion and a more accurate size assessment compared with bronchoscopy.