Arterial Spin-Labeling to Discriminate Pediatric Cervicofacial Soft-Tissue Vascular Anomalies

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Fig 1.
Illustrative cases of blood flow differences in major subtypes of STVA. Blood flow measured with ASL helps distinguish vascular anomalies. A–C, T2, T1, and ASL sequence blood flow maps. 1) Right intra- and periorbital hemangioma in a 6-month-old boy. ASL flow map demonstrates major lesional hyperperfusion (blood flow = 477 mL/100 g/min). 2) Intraorbital venous malformation of a 14-month-old boy with low blood flow (67 mL/min/100 g). 3) Intraosseous cystic lymphangioma of a 13-month-old girl with a low blood flow (45 mL/min/100 g).
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Fig 2.
Comparison of major STVA subtypes by using ASL blood flow maps. ASL blood flow values are plotted and labeled median on a 0- to 1000-mL/100 g/min base 10 logarithmic scale; error bars represent interquartile range. IH indicates infantile hemagioma; RICH and NICH indicate rapidly and noninvoluting congenital hemangioma.

Table 1:

Population characteristics^{^a}

Note:—ISSVA indicates International Society for the Study of Vascular Anomalies.
↵a Values are expressed as absolute number (percentage of total) or median (IQR).

Table 2:

Summary of baseline clinical and imaging characteristics by diagnostic category in major lesion subtypes^{^a}

Variable	Hemangiomas (n = 21)	Common Venous Malformations (n = 9)	Common Lymphatic Malformations (n = 10)
Age (yr)	1.46 (0.1–8.2)	4.6 (1.2–11)	2.65 (0.7–11.5)
Female sex	12 (57)	7 (78)	5 (50)
Median ASL flow	477 (212–603)	25 (15–66.5)	22.5 (16–60)
T1 signal	Iso: 15 (88)	Iso: 9 (100)	Iso: 6 (75)
T2 signal	Hyper: 19 (95)	Hyper: 9 (100)	Hyper: 10 (100)

Note:—Iso indicates isointense; Hyper, hyperintense.
↵a Values are expressed as absolute number (percentage of column total) or as mean (range) or median (25th–75th percentiles).