An institutional review of paediatric haemangiomas: prevalence, imaging features, and outcomes

Hong Kong Med J. 2010 Oct;16(5):334-40.

Abstract

Objective: To review the demographic data, imaging features, and outcomes of paediatric haemangiomas.

Design: Retrospective study.

Setting: University teaching hospital, Hong Kong.

Patients: A total of 58 children diagnosed with haemangioma between 1998 and 2007.

Main outcome measures: Demographic data, imaging features, type of treatment received, and outcomes.

Results: In all, 19 (33%) of these patients were males and 39 (67%) were females. Most of the lesions (64%) were in the head and neck region. Three (5%) of the patients were complicated by the Kasabach-Merritt syndrome; 21 underwent no imaging, and 37 had ultrasound and/or magnetic resonance imaging. In the majority (85%), ultrasound of the lesions revealed mixed echogenicity and/or phleboliths with variable colour Doppler patterns. On magnetic resonance imaging, most (87%) of the lesions were T1 iso- to hypo-intense and T2 hyperintense with slight heterogeneous signalling and revealed presence of central flow voids (vascular channels) or low-signal areas (fibrous tissue or calcification). In all, 85% appeared homogeneous while 15% showed heterogeneous enhancement. Of 58 patients, 39 (67%) patients received conservative treatment; the lesions resolved spontaneously in 34 (87%) patients, enlarged in 2 (5%), and remained static in 3 (8%). Interventions were directed at the lesions in 19 patients. These entailed surgical excision (n=7), argon laser therapy (n=3), and medical treatment (n=9). Of the latter patients, treatment included: systemic steroids (n=5), interferon (n=1), steroids and interferon (n=1), vincristine (n=1), and sclerotherapy (n=1). Partial or complete resolution of the lesions ensued in 15 (79%) of the patients, while their size remained static in four (21%).

Conclusion: Though ultrasound and magnetic resonance imaging features varied, the diagnosis of most haemangiomas could be confidently made by imaging. About 33% of haemangiomas underwent surgical/medical interventions, for which imaging was useful to monitor post-treatment progress.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hemangioma / diagnosis
  • Hemangioma / pathology
  • Hemangioma / therapy*
  • Hong Kong
  • Hospitals, University
  • Humans
  • Infant
  • Magnetic Resonance Imaging / methods*
  • Male
  • Retrospective Studies
  • Treatment Outcome
  • Ultrasonography, Doppler, Color / methods*