Vascular lesions in children: percutaneous MR imaging-guided interstitial Nd:YAG laser therapy--preliminary experience.
OBJECTIVE
To investigate the use of magnetic resonance (MR) imaging to guide interstitial laser therapy of deep hemangiomas and vascular malformations in children.


METHODS
Sixteen children aged 3 months to 16 years with symptomatic vascular lesions underwent percutaneous laser treatment. MR imaging guidance of the laser applicator and online thermomonitoring with MR imaging were performed with a 0.2-T open MR system. Follow-up studies were performed 2 days and 6 weeks after thermotherapy.


RESULTS
Interactive positioning of the laser applicator was possible in all patients. Online thermomonitoring was possible in 122 of 137 therapy spots (89%). There was a good correlation between volumes of coagulated tissue on intraprocedural T1-weighted images and volumes of coagulated tissue on follow-up T2-weighted images. At 6-week follow-up, MR imaging demonstrated a reduction in lesion size in 10 patients (mean reduction, 72%) and an increase in lesion size in two patients (mean increase, 134%). Clinical symptoms improved in 14 of 16 patients (88%).


CONCLUSIONS
MR imaging-guided laser therapy appears to be a safe and potentially effective minimally invasive treatment for selected children with vascular lesions.
Department of Radiology, Benjamin Franklin Hospital, Free University Berlin, Germany. wacker@ukbf.fu-berlin.de
F K
FK
Wacker
D
D
Cholewa
A
A
Roggan
A
A
Schilling
J
J
Waldschmidt
K J
KJ
Wolf
D000293:Adolescent; D001165:Arteriovenous Malformations / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006391:Hemangioma / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation*; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008297:Male; D009862:Online Systems; D016896:Treatment Outcome