Baker L L, Dillon W P, Hieshima G B, Dowd C F, Frieden I J
Department of Radiology, University of California, San Francisco 94143-0628.
AJNR Am J Neuroradiol. 1993 Mar-Apr;14(2):307-14.
To characterize the MR appearance of the common hemangioma of infancy as well as low- and high-flow vascular malformations of the head and neck.
Twenty patients with vascular lesions of the head and neck proved either by pathology, angiography, and/or unequivocal clinical diagnosis were included. Vascular lesions included 15 low-flow lesions (four hemangiomas, 10 venous malformations, one lymphatic malformation), and five high-flow lesions (three arteriovenous malformations (AVMs) and two invasive combined malformations). All patients had MR studies (generally 1.5 T using routine T1- and T2-weighted spin-echo sequences). Nine had postgadolinium, gradient recalled-echo, CT, and/or angiographic studies.
Deep hemangiomas and venous malformations demonstrate intermediate signal in T1-weighted images, heterogeneous high signal on T2-weighted images, and prominent enhancement. Involuting hemangiomas show focal areas of high signal intensity on T1-weighted images due to fatty replacement. Venous malformations may demonstrate venous lakes seen as homogeneous regions of high signal intensity on T2-weighted images and phleboliths seen as low signal foci. The one patient with lymphatic malformation showed a large multicystic submandibular mass with large hemorrhage-fluid levels. Features of high-flow lesions (AVMs) include serpiginous signal voids, absence of a dominant mass, and intraosseous extension with decreased marrow signal on T1-weighted images. Invasive combined vascular malformations showed serpiginous flow voids and infiltrative solid masses. Low-flow lesions (hemangiomas, venous, and lymphatic malformations) demonstrate distinct MR findings allowing their differentiation from high-flow lesions (AVMs). Deep hemangiomas and venous malformations appear as solid masses and may look identical. Venous lakes and phleboliths are features of venous malformations which, when present, may help in diagnosis. Combined vascular malformations share features of both low- and high-flow malformations.
MR is useful in delineating the extent of disease and differentiating low- and high-flow vascular lesions.
描述婴儿期常见血管瘤以及头颈部低流量和高流量血管畸形的磁共振成像（MR）表现。
纳入20例经病理、血管造影和/或明确临床诊断证实的头颈部血管病变患者。血管病变包括15例低流量病变（4例血管瘤、10例静脉畸形、1例淋巴管畸形）和5例高流量病变（3例动静脉畸形（AVM）和2例侵袭性复合畸形）。所有患者均进行了MR检查（一般采用1.5T，使用常规T1加权和T2加权自旋回波序列）。9例患者进行了钆增强、梯度回波、CT和/或血管造影检查。
深部血管瘤和静脉畸形在T1加权图像上呈中等信号，在T2加权图像上呈不均匀高信号，并显著强化。消退期血管瘤由于脂肪替代在T1加权图像上显示高信号强度的局灶性区域。静脉畸形在T2加权图像上可显示为高信号强度均匀区域的静脉湖以及低信号灶的静脉石。1例淋巴管畸形患者表现为下颌下区巨大多囊性肿块，伴有大量出血-液平面。高流量病变（AVM）的特征包括蜿蜒的信号缺失、无明显肿块以及在T1加权图像上骨髓信号降低的骨内延伸。侵袭性复合血管畸形表现为蜿蜒的血流缺失和浸润性实性肿块。低流量病变（血管瘤、静脉和淋巴管畸形）具有独特的MR表现，可与高流量病变（AVM）相鉴别。深部血管瘤和静脉畸形表现为实性肿块，可能看起来相同。静脉湖和静脉石是静脉畸形的特征，出现时可能有助于诊断。复合血管畸形兼具低流量和高流量畸形的特征。
MR有助于描绘疾病范围并区分低流量和高流量血管病变。
