Locally aggressive and borderline VTs present shortly after birth and may present with thrombocytopenia and/or a consumptive coagulopathy, which can complicate treatment. Malignant VTs are rapidly growing masses found in children of all ages, are often more aggressive than similar tumors in adults, and may be difficult to accurately diagnose due to poorly differentiated cell type [4,6]. Initial Imaging Definition Initial imaging is defined as imaging at the beginning of the care episode for the medical condition defined by the variant. More than one procedure can be considered usually appropriate in the initial imaging evaluation when: The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org OR Discussion of Procedures by Variant Variant 1: Infant. Clinical signs or symptoms of infantile hemangioma. Initial imaging. Infantile hemangiomas are the most common benign neoplasm of infancy, with a prevalence of 4% to 5% [13]. Infantile hemangiomas, distinct from VMs, are a true neoplasm rather than an abnormality of embryonic development of vascular tissue (see Appendix 1). They become clinically evident within the first few weeks of life and progress through phases of latency, growth, and plateau, predictably by the first year of life; in rare cases, growth continues through 24 months of age. With either complete or partial involution, lesion regression is completed by 4 years of age in 90% of cases but may continue through to 8 years of age [13,14].
Soft Tissue Vascular Anomalies Vascular Malformations and Infantile Vascular Tumors Non CNS Child. Locally aggressive and borderline VTs present shortly after birth and may present with thrombocytopenia and/or a consumptive coagulopathy, which can complicate treatment. Malignant VTs are rapidly growing masses found in children of all ages, are often more aggressive than similar tumors in adults, and may be difficult to accurately diagnose due to poorly differentiated cell type [4,6]. Initial Imaging Definition Initial imaging is defined as imaging at the beginning of the care episode for the medical condition defined by the variant. More than one procedure can be considered usually appropriate in the initial imaging evaluation when: The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org OR Discussion of Procedures by Variant Variant 1: Infant. Clinical signs or symptoms of infantile hemangioma. Initial imaging. Infantile hemangiomas are the most common benign neoplasm of infancy, with a prevalence of 4% to 5% [13]. Infantile hemangiomas, distinct from VMs, are a true neoplasm rather than an abnormality of embryonic development of vascular tissue (see Appendix 1). They become clinically evident within the first few weeks of life and progress through phases of latency, growth, and plateau, predictably by the first year of life; in rare cases, growth continues through 24 months of age. With either complete or partial involution, lesion regression is completed by 4 years of age in 90% of cases but may continue through to 8 years of age [13,14].