Imaging characteristics of two subtypes of congenital hemangiomas: rapidly involuting congenital hemangiomas and non-involuting congenital hemangiomas.
BACKGROUND
Common infantile hemangiomas (COMMON) occur in approximately 10% of infants by the age of 1 year, with a female predominance. Some hemangiomas can be fully developed at birth and are thus called congenital hemangiomas (CH). Within this population, two courses have been identified: rapidly involuting CH (RICH) and non-involuting CH (NICH). Little has been reported on the clinical prognosis and imaging features of these entities.


OBJECTIVE
To describe the imaging characteristics of two subtypes of CH, i.e. RICH and NICH, and to compare them with COMMON.


METHODS
We retrospectively gathered data on 26 children presenting with CH, i.e. lesions fully developed at birth. These lesions were divided into two groups according to the clinical course: suspected RICH (n=8) and suspected NICH (n=18). We used US, CT or MRI and angiography to identify the gross anatomy and structure and the vascularization. Imaging findings were compared with the clinical course and pathology results, when available. The imaging findings in these patients were compared retrospectively with those in 26 patients with COMMON randomly chosen from the database of our multidisciplinary clinic.


RESULTS
When compared with COMMON imaging characteristics, NICH and RICH had distinctive features on US such as being heterogeneous (72% of NICH and 62.5% of RICH vs 42.3% of COMMON), visible vessels (72% of NICH and 62.5% of RICH vs 15.4% of COMMON), calcifications (17% of NICH and 37.5% of RICH vs no case of COMMON). On CT and/or MRI, we compared imaging features such as well-defined limits (67% of NICH and 60% of RICH vs 100% of COMMON), and fat stranding (29.4% of NICH and RICH vs 7.7% of COMMON).


CONCLUSIONS
Distinctive imaging characteristics are observed in cases of CH with US findings of visible vessels and calcifications statistically significant.
Gorincour
Guillaume
G
Department of Medical Imaging, Sainte Justine Hospital, 3175 Cote Sainte Catherine, Montreal, QC, H3T 1C5, Canada.
Kokta
Victor
V
Rypens
Francoise
F
Garel
Laurent
L
Powell
Julie
J
Dubois
Josée
J
D000293:Adolescent; D000792:Angiography; D002648:Child; D002675:Child, Preschool; D005260:Female; D006391:Hemangioma / Q000145:classification / Q000151:congenital* / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D018608:Ultrasonography, Doppler