Soft-tissue vascular anomalies: Utility of US for diagnosis

PURPOSE: To determine the ultrasonographic (US) features that distinguish s oft-tissue hemangioma from vascular malformation and one type of malformati on from another. MATERIALS AND METHODS: Eighty-seven vascular anomalies were evaluated by me ans of US. Lesions were assessed for the presence of solid tissue and abnor mal arteries, veins, or cysts. Vessel density, peak flow velocities, and re sistive indexes were compared. RESULTS: There were 49 hemangiomas and 38 vascular malformations. A signifi cantly greater proportion of hemangiomas (48 of 49) compared with vascular malformations (zero of 38) consisted of a solid-tissue mass (P < .001). Ves sel density was comparable for hemangioma and arteriovenous malformation (A VM) but Significantly greater compared with the other vascular malformation s (P < .001 in each case). No differences in mean arterial peak velocity we re detected between hemangiomas and malformations. Mean venous peak velocit y was significantly higher for AVM than for other vascular malformations an d hemangioma. Mean resistive index was greater for lymphatic malformation t han for hemangioma or AVM. Abnormal veins, arteries and veins, or cysts wer e univariate predictors for distinguishing between venous, arteriovenous, a nd lymphatic malformations (P < .001 in all cases). Solid-tissue mass was t he only multivariate predictor for differentiating hemangioma from vascular malformation (likelihood ratio test = 109.8, P < .001). CONCLUSION: US can be used to distinguish hemangioma from vascular malforma tion and detect arterial flow. These distinctions are critical for subseque nt management and assessing prognosis.