EFFICACY OF MAGNETIC-RESONANCE ANGIOGRAPHY IN THE EVALUATION OF VASCULAR MALFORMATIONS OF THE HAND

Conventional arteriography has been the accepted standard technique fo r demonstrating the anatomic details in vascular malformations of the hand. The technique of magnetic resonance angiography provides detaile d anatomy for vascular anomalies of the hand without the use of an inv asive technique or contrast enhancement. When magnetic resonance angio graphy is combined with magnetic resonance imaging, the extent of the lesion with respect to the surrounding tissues and the flow characteri stics of the lesion can be determined noninvasively. In our institutio n, magnetic resonance angiography has replaced conventional arteriogra phy as the technique of choice for the evaluation of these lesions. Th is report evaluates the efficacy of magnetic resonance imaging/magneti c resonance angiography in the management of vascular malformations of the hand. Ten consecutive patients over 30 months (median age 37 year s) underwent magnetic resonance imaging/magnetic resonance angiography evaluation after the clinical diagnosis of a vascular malformation of the hand was made. Four patients in the group had conventional arteri ography performed before referral. Magnetic resonance imaging/magnetic resonance angiography clearly defined the anatomic extent of the lesi on, its relationship to surrounding tissues, and the flow characterist ics in each patient. In the four patients in whom conventional arterio graphy had been performed, the magnetic resonance angiography findings matched the arteriographic findings. On the basis of the magnetic res onance imaging/magnetic resonance angiography findings, six patients w ere treated nonoperatively with compressive garments and four patients had operative treatment (resection of lesion n = 2, digital ray resec tion n = 2). In this series, magnetic resonance imaging/magnetic reson ance angiography was efficacious in the management of vascular malform ations of the hand. This technique provides detailed images of both th e arterial and venous components of the lesions without the requiremen ts of contrast enhancement, ionizing radiation, or an invasive procedu re. Furthermore, the resectability can be determined based on the exte nt of involvement and the flow characteristics.