MRI evaluation of soft tissue vascular malformations

Abstract

Background: Soft tissue vascular malformations are not uncommonly encountered in clinical practice and are often mistaken for other pathologies. Vascular anomalies are divided into vascular tumors and malformations. Vascular malformations progressively increase in size with increasing age and are classified into low-flow (venous, lymphatic, veno-lymphatic, capillary and capillary venous) and high-flow malformations (arteriovenous malformations (AVM) and arteriovenous fistula (AVF)) depending on the presence or absence of arterial flow. Aim: Aim of this study is to evaluate the Magnetic resonance imaging (MRI) features of the soft tissue vascular malformations and to classify the lesions depending on flow pattern. Materials and Methods: A total of 52 patients of soft tissue vascular malformations were included in this study over a period of 3 years. All patients underwent detailed clinical examination and dynamic post contrast MRI evaluation. Doppler and ultrasound were done as an adjunct. Results: There were 31 females and 21 male patients with age ranging from 9 to 34 years. In total 33 venous, 11 lymphatic, 8 veno-lymphatic malformations were seen. No case of high-flow malformation was seen. Majority of the lesions involved the head and neck region and the extremities. Fat saturated T2WI, STIR, and 3D dynamic post contrast sequences were found to be the most useful MRI sequences. Conclusion: MRI is the modality of choice for evaluating the soft tissue vascular malformations. It depicts the extent of the lesion, classifies the lesions into low or high flow and helps in treatment planning.