Marcelin C, Dubois J, Kokta V, Giroux M F, Danino M A, Mottard S, Soulez G
Department of Adult Diagnostic and Interventional Radiology, Hôpital Pellegrin place Amélie-Raba-Léon, 33076, Bordeaux, France.
Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.
Insights Imaging. 2024 Jun 9;15(1):135. doi: 10.1186/s13244-024-01712-w.
To compare the magnetic resonance imaging (MRI) and Doppler ultrasound (DUS) findings with the pathological findings of soft tissue vascular tumors (STVTs) according to the 2018 ISSVA (International Society for the Study of Vascular Anomalies) classification to differentiate vascular tumors from vascular malformations.
This retrospective study included patients with STVTs who underwent contrast-enhanced MRI and pathological analysis at our hospital between 2010 and 2020. The presumptive diagnosis based on the on-site imaging and histological analysis was compared with imaging and histological analysis conducted off-site utilizing the ISSVA criteria.
This study included 31 patients with 31 vascular tumors located in the head and neck (n = 3), trunk (n = 2), and extremities (n = 26). The off-site pathological analysis confirmed benign vascular tumors in 54.8% of cases (non-involuting congenital hemangioma: 35.5%; epithelioid hemangioma: 13%; pyogenic granuloma: 3%; and spindle cell hemangioma: 3%). Based on the off-site histological analysis, 25.8% were reclassified as having a vascular malformation whereas three had other benign lesions. Only phleboliths were associated with a vascular malformation (p = 0.03). The concordance between off-site MRI and pathological findings was fair (k = 0.3902 (0.0531-0.7274)), whereas that between on-site and off-site pathological analyses was poor (k = -0.0949 (-0.4661 to 0.2763)).
Benign vascular tumors have non-specific imaging features on imaging with some overlap with atypical vascular malformations. Therefore, histological analysis is recommended. Imaging and pathological analyses should be performed in accordance with the ISSVA classification to minimize inter-observer discrepancies.
Imaging features of benign vascular tumors on MRI are non-specific, leading to discrepancies with pathological findings and potential overlap with atypical vascular malformations. Imaging and histological analyses should be performed in accordance with ISSVA guidelines to improve patient management.
The imaging features of benign vascular tumors are non-specific. Histological analysis is recommended for soft tissue vascular tumors in adults. Analyses of soft tissue vascular tumors should be performed in accordance with ISSVA guidelines.
根据2018年国际血管异常研究学会（ISSVA）分类，比较软组织血管肿瘤（STVTs）的磁共振成像（MRI）和多普勒超声（DUS）表现与病理表现，以区分血管肿瘤和血管畸形。
这项回顾性研究纳入了2010年至2020年间在我院接受增强MRI和病理分析的STVTs患者。将基于现场成像和组织学分析的初步诊断与利用ISSVA标准在非现场进行的成像和组织学分析进行比较。
本研究包括31例患者，共31个血管肿瘤，位于头颈部（n = 3）、躯干（n = 2）和四肢（n = 26）。非现场病理分析证实54.8%的病例为良性血管肿瘤（非消退性先天性血管瘤：35.5%；上皮样血管瘤：13%；化脓性肉芽肿：3%；梭形细胞血管瘤：3%）。根据非现场组织学分析，25.8%被重新分类为血管畸形，而3例有其他良性病变。只有静脉石与血管畸形相关（p = 0.03）。非现场MRI与病理结果之间的一致性一般（k = 0.3902（0.0531 - 0.7274）），而现场与非现场病理分析之间的一致性较差（k = -0.0949（-0.4661至0.2763））。
良性血管肿瘤在影像学上具有非特异性表现，与非典型血管畸形有一定重叠。因此，建议进行组织学分析。应根据ISSVA分类进行成像和病理分析，以尽量减少观察者之间的差异。
MRI上良性血管肿瘤的影像学特征不具有特异性，导致与病理结果存在差异，并可能与非典型血管畸形重叠。应根据ISSVA指南进行成像和组织学分析，以改善患者管理。
良性血管肿瘤的影像学特征不具有特异性。对于成人软组织血管肿瘤，建议进行组织学分析。软组织血管肿瘤的分析应根据ISSVA指南进行。
