Which imaging studies are indicated in the workup of infantile hemangiomas?

Updated: Nov 09, 2020
  • Author: Richard J Antaya, MD; Chief Editor: William D James, MD  more...
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MRI with and without intravenous gadolinium is the imaging modality of choice to delineate the location and extent of both cutaneous and extracutaneous hemangiomas. MRI also helps in differentiating other high-flow vascular lesions (eg, arteriovenous malformations vs proliferating hemangiomas). Involuting hemangiomas have features that resemble low-flow lesions (eg, venous malformations).

Ultrasonography is useful in differentiating hemangiomas from other deep dermal or subcutaneous structures, such as cysts, pilomatrixomas, or lymph nodes. Ultrasonography is generally limited by its inability to fully evaluate the magnitude and extent of the hemangioma. Dubois et al found that an evaluation exhibiting high vessel density (>5 vessels/cm2) and high peak arterial Doppler shift (>2 kHz) was both sensitive and specific for infantile hemangiomas compared with other soft-tissue masses. [7]

Plain radiography is fairly limited but may be useful for evaluating hemangiomas that impinge on the airway.

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