PURPOSE: To review the angiograms in patients with hepatic hemangiomas referred to two North American children's hospitals to determine the variability in angiographic findings and to propose a classification system that is based on these findings. MATERIALS AND METHODS: Angiograms obtained in 15 infants with a diagnosis of hepatic hemangioma who were examined at or referred to two tertiary pediatric hospitals in North America from 1981 through 2000 were reviewed. The angiographic findings were then used to classify hemangiomas into types on the basis of a number of features, including high-flow nodules, early filling of veins, and the type of direct shunt present. Clinical data, including age at presentation, presence of cardiac insufficiency, and treatment, were also recorded. RESULTS: Lesions were classified into five types on the basis of angiographic findings. In three of 15 patients, angiograms demonstrated the classic appearance of hepatic hemangiomas, with early filling of abnormal vascular channels, stagnation of contrast material, and no evidence of a direct shunt (type 1). In four patients, images showed high-flow nodules without direct shunts (type 2). In eight patients, direct shunts were demonstrated: arteriovenous shunts (type 3) in one, portovenous shunts (type 4) in three, and both arteriovenous and portovenous shunts (type 5) in four. CONCLUSION: Hepatic hemangioma in infants is a heterogeneous lesion with variable angioarchitecture and a spectrum of angiographic findings.
PURPOSE: To review the angiograms in patients with hepatic hemangiomas referred to two North American children's hospitals to determine the variability in angiographic findings and to propose a classification system that is based on these findings. MATERIALS AND METHODS: Angiograms obtained in 15 infants with a diagnosis of hepatic hemangioma who were examined at or referred to two tertiary pediatric hospitals in North America from 1981 through 2000 were reviewed. The angiographic findings were then used to classify hemangiomas into types on the basis of a number of features, including high-flow nodules, early filling of veins, and the type of direct shunt present. Clinical data, including age at presentation, presence of cardiac insufficiency, and treatment, were also recorded. RESULTS: Lesions were classified into five types on the basis of angiographic findings. In three of 15 patients, angiograms demonstrated the classic appearance of hepatic hemangiomas, with early filling of abnormal vascular channels, stagnation of contrast material, and no evidence of a direct shunt (type 1). In four patients, images showed high-flow nodules without direct shunts (type 2). In eight patients, direct shunts were demonstrated: arteriovenous shunts (type 3) in one, portovenous shunts (type 4) in three, and both arteriovenous and portovenous shunts (type 5) in four. CONCLUSION:Hepatic hemangioma in infants is a heterogeneous lesion with variable angioarchitecture and a spectrum of angiographic findings.
Authors: Suhail Al-Saleh; Philip R John; Michelle Letarte; Marie E Faughnan; Jaques Belik; Felix Ratjen Journal: Pediatrics Date: 2011-05-02 Impact factor: 7.124
Authors: Sandeep Vaidya; Daniel Cooke; Matthew Kogut; Peter G Stratil; Mark A Bittles; Manrita Sidhu Journal: Semin Intervent Radiol Date: 2008-09 Impact factor: 1.513