Magnetic resonance imaging application in infantile hemangiomas and vascular malformations

Aim. The aim of this paper was to review the role of modern diagnostic imaging in the evaluation of patients with vascular anomalies: hemangiomas and vascular malformations. Methods. We have analyzed 20 pediatric patients using the magnetic resonance imaging (MRI) and the magnetic resonance angiography. For each pathology, we have compared the literature findings with our clinical cases. Results. MRI leaves some doubts in the diagnosis of 2 types of lesions. The first type concerns the high-flow lesions: in this case the differential diagnosis among a small arteriovenous fistula, a hemangioma in the proliferation phase, a venous malformation with high feeding arteries and an arteriovenous malformation in the preclinical phase can be impossible. The second type concerns the low-flow lesions, in which the diagnosis of combined vascular malformations such as venolymphatic malformations can be very difficult. Conclusion. Nowadays, MRI is the best technology in order to provide information about type, location and extension of this type of lesions. It is not invasive neither dangerous, does not require the use of ionizing radiations, and presents minimum disadvantages as sedation. Nevertheless, MRI alone is not sufficient to provide the necessary informations for the diagnosis and treatment of all vascular anomalies.