Lymphatic VMs are also able to be at least partially characterized by grayscale US when multiple anechoic spaces with cysts, which may contain fluid-fluid levels in the event there has been prior infection or hemorrhage into the lesion, that are noncompressible are visualized. Venolymphatic VMs show a combination of the above features. Fast-flow VM-AVMs and AVFs show a cluster of vessels without an associated solid tissue mass [36,37] in contradistinction to hemangiomas. Congenital hepatic hemangiomas are focal lesions of the liver associated with multiple cutaneous infantile hemangiomas. US Area of Interest With IV Contrast US of the abdomen and pelvis 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 sensitivity and diagnostic confidence, particularly for focal lesions, which 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 US of the abdomen and pelvis 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 Area of Interest US with duplex Doppler may be used to distinguish characteristic features of VTs, verify arterial waveforms in fast- flow VMs (arterialization of draining veins), and differentiate between low-flow and fast-flow VMs. Aside from Soft Tissue Vascular Anomalies-Child infantile hemangioma, VTs typically demonstrate both arterial and venous waveforms.
Soft Tissue Vascular Anomalies Vascular Malformations and Infantile Vascular Tumors Non CNS Child. Lymphatic VMs are also able to be at least partially characterized by grayscale US when multiple anechoic spaces with cysts, which may contain fluid-fluid levels in the event there has been prior infection or hemorrhage into the lesion, that are noncompressible are visualized. Venolymphatic VMs show a combination of the above features. Fast-flow VM-AVMs and AVFs show a cluster of vessels without an associated solid tissue mass [36,37] in contradistinction to hemangiomas. Congenital hepatic hemangiomas are focal lesions of the liver associated with multiple cutaneous infantile hemangiomas. US Area of Interest With IV Contrast US of the abdomen and pelvis 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 sensitivity and diagnostic confidence, particularly for focal lesions, which 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 US of the abdomen and pelvis 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 Area of Interest US with duplex Doppler may be used to distinguish characteristic features of VTs, verify arterial waveforms in fast- flow VMs (arterialization of draining veins), and differentiate between low-flow and fast-flow VMs. Aside from Soft Tissue Vascular Anomalies-Child infantile hemangioma, VTs typically demonstrate both arterial and venous waveforms.