Radiographs may also better characterize imaging artifacts (embolization coils), which may limit the evaluation of residual VM on MRI/US [35]. US Area of Interest US area of interest may be useful as an initial imaging modality in patients with an established diagnosis of VM when presenting with new or persistent signs or symptoms. However, US may be limited if there is extensive embolization material present. VM occlusions directly due to embolization versus associated soft tissue swelling from treatment changes can be visualized on grayscale US. US Area of Interest With IV Contrast There is no relevant literature to support the use of US area of interest with IV contrast as the initial imaging modality for patients with an established diagnosis of VM presenting with new or persistent signs and symptoms. It has been shown that the dynamics of blood flow through VM can be determined using contrast-enhanced US, and that differences in blood flow dynamics as measured using time intensity curve analysis can be shown by comparing pretreatment and post-treatment examinations [50]. US Duplex Doppler Area of Interest US with duplex Doppler may be helpful as an initial imaging modality in patients with an established diagnosis of VM when presenting with new or persistent signs or symptoms. Doppler US can help distinguish changes following Soft Tissue Vascular Anomalies-Child enhanced US and that differences in blood flow dynamics as measured using time intensity curve analysis can be shown by comparing pretreatment and post-treatment examinations. Supporting Documents The evidence table, literature search, and appendix for this topic are available at https://acsearch. acr.org/list. The appendix includes the strength of evidence assessment and the final rating round tabulations for each recommendation. For additional information on the Appropriateness Criteria methodology and other supporting documents go to www. acr.org/ac.
Soft Tissue Vascular Anomalies Vascular Malformations and Infantile Vascular Tumors Non CNS Child. Radiographs may also better characterize imaging artifacts (embolization coils), which may limit the evaluation of residual VM on MRI/US [35]. US Area of Interest US area of interest may be useful as an initial imaging modality in patients with an established diagnosis of VM when presenting with new or persistent signs or symptoms. However, US may be limited if there is extensive embolization material present. VM occlusions directly due to embolization versus associated soft tissue swelling from treatment changes can be visualized on grayscale US. US Area of Interest With IV Contrast There is no relevant literature to support the use of US area of interest with IV contrast as the initial imaging modality for patients with an established diagnosis of VM presenting with new or persistent signs and symptoms. It has been shown that the dynamics of blood flow through VM can be determined using contrast-enhanced US, and that differences in blood flow dynamics as measured using time intensity curve analysis can be shown by comparing pretreatment and post-treatment examinations [50]. US Duplex Doppler Area of Interest US with duplex Doppler may be helpful as an initial imaging modality in patients with an established diagnosis of VM when presenting with new or persistent signs or symptoms. Doppler US can help distinguish changes following Soft Tissue Vascular Anomalies-Child enhanced US and that differences in blood flow dynamics as measured using time intensity curve analysis can be shown by comparing pretreatment and post-treatment examinations. Supporting Documents The evidence table, literature search, and appendix for this topic are available at https://acsearch. acr.org/list. The appendix includes the strength of evidence assessment and the final rating round tabulations for each recommendation. For additional information on the Appropriateness Criteria methodology and other supporting documents go to www. acr.org/ac.