US Abdomen With IV Contrast US of the abdomen with IV contrast, specifically for evaluation of the liver, for the presence of hepatic hemangiomas in infants with multiple cutaneous infantile hemangiomas may be used to increase the sensitivity and diagnostic confidence, particularly for focal lesions that are seen in congenital hepatic hemangiomas rather than the diffuse and multifocal hepatic hemangiomas seen in infantile hemangiomas [26,27]. The addition of IV contrast for Soft Tissue Vascular Anomalies-Child US of the abdomen has been shown by El-Ali et al [27] to differentiate infantile hepatic hemangioma in infants from congenital hemangioma of the liver in 5 infants based on the pattern of early and late arterial phase and delayed washout of IV contrast (P = . 0016). The IV contrast enhancement pattern on US was similar to the manner in which the lesions are known to enhance with IV contrast on CT and MRI examinations [28]. US Duplex Doppler Abdomen A recent guidance document of the American Society of Pediatric Hematology Oncology Vascular Anomalies Special Interest Group recommends Doppler US of the liver as the preferred initial imaging study. On US examination imaging features such as multifocal and diffuse patterns are more specific to infantile hepatic hemangiomas and may be used to help differentiate them from congenital hemangiomas of the liver [25]. Solitary lesions may be larger in diameter and of heterogeneous echogenicity, with more prominent peripheral vascular components [26]. Variant 3: Child. Clinical signs or symptoms of vascular anomaly (tumor or malformation) not suggesting infantile hemangioma. Initial imaging. VAs are a diverse group of lesions including tumors with benign, locally aggressive, or malignant behaviors and malformations, which may involve low-flow (venous or lymphatic) or fast-flow (arterial) blood flow [4] (see Appendix 1).
Soft Tissue Vascular Anomalies Vascular Malformations and Infantile Vascular Tumors Non CNS Child. US Abdomen With IV Contrast US of the abdomen with IV contrast, specifically for evaluation of the liver, for the presence of hepatic hemangiomas in infants with multiple cutaneous infantile hemangiomas may be used to increase the sensitivity and diagnostic confidence, particularly for focal lesions that are seen in congenital hepatic hemangiomas rather than the diffuse and multifocal hepatic hemangiomas seen in infantile hemangiomas [26,27]. The addition of IV contrast for Soft Tissue Vascular Anomalies-Child US of the abdomen has been shown by El-Ali et al [27] to differentiate infantile hepatic hemangioma in infants from congenital hemangioma of the liver in 5 infants based on the pattern of early and late arterial phase and delayed washout of IV contrast (P = . 0016). The IV contrast enhancement pattern on US was similar to the manner in which the lesions are known to enhance with IV contrast on CT and MRI examinations [28]. US Duplex Doppler Abdomen A recent guidance document of the American Society of Pediatric Hematology Oncology Vascular Anomalies Special Interest Group recommends Doppler US of the liver as the preferred initial imaging study. On US examination imaging features such as multifocal and diffuse patterns are more specific to infantile hepatic hemangiomas and may be used to help differentiate them from congenital hemangiomas of the liver [25]. Solitary lesions may be larger in diameter and of heterogeneous echogenicity, with more prominent peripheral vascular components [26]. Variant 3: Child. Clinical signs or symptoms of vascular anomaly (tumor or malformation) not suggesting infantile hemangioma. Initial imaging. VAs are a diverse group of lesions including tumors with benign, locally aggressive, or malignant behaviors and malformations, which may involve low-flow (venous or lymphatic) or fast-flow (arterial) blood flow [4] (see Appendix 1).