Yilmaz Kahraman Berkhan, Canter Halil Ibrahim, Vargel Ibrahim, Ormeci Tugrul, Can Ulas, Turk Ali, Saygili Ozlem
Department of Plastic and Reconstructive Surgery, Acibadem University Faculty of Medicine, Istanbul, Turkey.
J Craniofac Surg. 2011 Sep;22(5):1814-8. doi: 10.1097/SCS.0b013e31822f3b05.
Hemangiomas (proliferating endothelial tumors) are the most common benign tumors of infancy. Most often hemangiomas are self-regressing lesions without any treatment. Approximately 10% of hemangiomas cause complications such as major ulceration/destruction, distortion of involved tissues, and obstruction of a vital structure. When the situation becomes complicated, there are different treatment alternatives, ranging from systemic or local corticosteroid use to surgery. Sclerotherapy using intralesional polidocanol (Aethoxysklerol) injection may be used before surgery to decrease blood loss or when a vital structure of the face is in danger because of sudden increase in size of a surrounding hemangioma. Before any kind of treatment for both hemangiomas and vascular malformations, preoperative diagnosis and anatomic position of the lesion must be documented thoroughly. With the help of magnetic resonance imaging, tridimensional vascular pattern of such lesions can be shown successfully. We used three-dimensional contrast-enhanced time-resolved magnetic resonance angiography to detect the changes of lesions for 2 children who have large hemangiomas on their faces, before and after sclerotherapy with polidocanol injection. The findings of three-dimensional magnetic resonance imaging studies help to better assess the success rate of treatment not only for us as the physicians but also for the parents of these children who cannot understand anything with standard two-dimensional radiologic imaging.
血管瘤（增殖性内皮肿瘤）是婴儿期最常见的良性肿瘤。大多数血管瘤是无需任何治疗即可自行消退的病变。约10%的血管瘤会引起并发症，如严重溃疡/破坏、受累组织变形以及重要结构梗阻。当情况变得复杂时，有不同的治疗选择，从全身或局部使用皮质类固醇到手术治疗。在手术前，可使用病灶内注射聚多卡醇（聚桂醇）进行硬化治疗，以减少失血，或者当面部重要结构因周围血管瘤突然增大而处于危险中时使用。在对血管瘤和血管畸形进行任何治疗之前，必须彻底记录病变的术前诊断和解剖位置。借助磁共振成像，可以成功显示此类病变的三维血管形态。我们使用三维对比增强时间分辨磁共振血管造影术，对2名面部患有大型血管瘤的儿童在聚多卡醇注射硬化治疗前后进行病变检测。三维磁共振成像研究结果不仅有助于我们医生更好地评估治疗成功率，也有助于这些孩子的父母，他们无法通过标准的二维放射成像理解任何情况。
