Peripheral vascular malformations: Imaging, treatment approaches, and therapeutic issues

被引:124
作者
Hyodoh, H [1 ]
Hori, M [1 ]
Akiba, H [1 ]
Tamakawa, M [1 ]
Hyodoh, K [1 ]
Hareyama, M [1 ]
机构
[1] Sapporo Med Univ, Dept Radiol, Chuo Ku, Sapporo, Hokkaido 0608543, Japan
关键词
D O I
10.1148/rg.25si055509
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Peripheral vascular malformations are now described according to some accepted guidelines, and the principle of proper treatment (nidus ablation) is becoming clear. An appropriate classification scheme for vascular anomalies and definite indications for treatment are important to successful treatment overall. The findings from noninvasive imaging (ie, Doppler ultrasonography, computed tomography, or magnetic resonance imaging) in association with clinical findings are critical in establishing the diagnosis, evaluating the extent of the malformation, and planning appropriate treatment. Direct opacification of the nidus is useful, not only in making a correct diagnosis, but also in treating the lesion with sclerotherapy. In most cases, conservative treatment is recommended, but when a patient suffers clinical complications (eg, ulceration, pain, hemorrhage, cardiac failure, or unacceptable cosmetic consequences), the nidus sclerotherapy becomes mandatory. If the vascular malformation has blood outflow to a drainage vein during nidus opacification, flow control (with balloon occlusion, tourniquet, or embolization) is necessary to achieve sclerosant stasis within the nidus. Embolotherapy (with a coil, n-butyl cyanoacrylate, or small particles) should be used for subsequent multifaceted palliative therapy. A multi-disciplinary approach is needed in the treatment of a high-flow lesion, and a dedicated team approach is necessary for appropriate management in most cases. (c) RSNA, 2005.
引用
收藏
页码:S159 / S172
页数:14
相关论文
共 41 条
[1]   Hereditary haemorrhagic telangiectasia (Osier-Weber-Rendu syndrome): a view from the 21st century [J].
Begbie, ME ;
Wallace, GMF ;
Shovlin, CL .
POSTGRADUATE MEDICAL JOURNAL, 2003, 79 (927) :18-24
[2]   Sclerotherapy of craniofacial venous malformations: Complications and results [J].
Berenguer, B ;
Burrows, PE ;
Zurakowski, D ;
Mulliken, JB .
PLASTIC AND RECONSTRUCTIVE SURGERY, 1999, 104 (01) :1-11
[3]   Low-flow vascular malformations: MR-guided percutaneous sclerotherapy in qualitative and quantitative assessment of therapy and outcome [J].
Boll, DT ;
Merkle, EM ;
Lewin, JS .
RADIOLOGY, 2004, 233 (02) :376-384
[4]   MASSIVE THROMBOSIS PRODUCED BY FATTY ACID INFUSION [J].
CONNOR, WE ;
HOAK, JC ;
WARNER, ED .
JOURNAL OF CLINICAL INVESTIGATION, 1963, 42 (06) :860-&
[5]   Soft-tissue venous malformations in adult patients: Imaging and therapeutic issues [J].
Dubois, J ;
Soulez, G ;
Oliva, VL ;
Berthiaume, MJ ;
Lapierre, C ;
Therasse, E .
RADIOGRAPHICS, 2001, 21 (06) :1519-1531
[6]   Capillary malformation-arteriovenous malformation, a new clinical and genetic disorder caused by RASA1 mutations [J].
Eerola, I ;
Boon, LM ;
Mulliken, JB ;
Burrows, PE ;
Dompmartin, A ;
Watanabe, S ;
Vanwijck, R ;
Vikkula, M .
AMERICAN JOURNAL OF HUMAN GENETICS, 2003, 73 (06) :1240-1249
[7]  
Enjolras Odile, 1997, Journal of Dermatology (Tokyo), V24, P701
[8]   Hypoxia modulates adenosine receptors in human endothelial and smooth muscle cells toward an A2B angiogenic phenotype [J].
Feoktistov, I ;
Ryzhov, S ;
Zhong, HY ;
Goldstein, AE ;
Matafonov, A ;
Zeng, DW ;
Biaggioni, I .
HYPERTENSION, 2004, 44 (05) :649-654
[9]   Venous vascular malformations in pediatric patients: Comparison of results of alcohol sclerotherapy with proposed MR imaging classification [J].
Goyal, M ;
Causer, PA ;
Armstrong, D .
RADIOLOGY, 2002, 223 (03) :639-644
[10]   Ethanol sclerotherapy of venous malformations: Evaluation of systemic ethanol contamination [J].
Hammer, FD ;
Boon, LM ;
Mathurin, P ;
Vanwijck, RR .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2001, 12 (05) :595-600