Pediatric Head and Neck Lesions: Assessment of Vascularity by MR Digital Subtraction Angiography
Weng Kong Chooia,
Neil Woodhousea,
Stuart C. Coleya and
Paul D. Griffithsa
a From the Section of Academic Radiology, University of Sheffield, Royal Hallamshire Hospital, Sheffield, England
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FIG 1. Images from the case of a 3-year-old female patient with a suspected vascular abnormality of the scalp.
A, Unenhanced sagittal T1-weighted MR image shows an extra-calvarial soft tissue mass.
B, Marked uniform enhancement can be seen after the administration of contrast material. Serpiginous flow void represents an enlarged feeding vessel.
C, Selected MR digital subtraction angiograms show prominent filling of contrast material in the arterial phase and prominent enhancement of the lesion. This was considered to represent a high-flow lesion.
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FIG 2. Images from the case of a 14-month-old female patient with left-sided neck swelling.
A, Unenhanced axial T1-weighted MR image shows an encapsulated mass in the left parotid gland.
B, After the administration of contrast material, marked contrast enhancement is seen. Note the vascular flow voids within the lesion.
C, Selected MR digital subtraction angiograms show early arterial filling of the hypervascular lesion and arteriovenous shunting into an early draining vein. This is consistent with a parotid hemangioma in the proliferative phase.
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FIG 3. Images from the case of a 5-day-old female patient with a large occipital mass thought to be an encephalocele.
A, Sagittal T1-weighted MR image shows a large occipital mass with intermediate signal intensity.
B, More heterogeneous appearance can be seen on the T2-weighted image. No intracranial communication is shown.
C, Selected MR digital subtraction angiograms show rapid opacification of the lesion during the early arterial phase. Flow in this lesion was so high that the intracranial vessels are poorly shown. Pathologic examination revealed an undifferentiated highly vascular tumor.
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FIG 4. Images from the case of a 5-year-old male patient with a nasopharyngeal mass.
A, Lobulated nasopharyngeal mass is seen on the sagittal T2-weighted MR image.
B, T1-weighted coronal MR image also shows the lobulated nasopharyngeal mass.
C, Coronal contrast-enhanced fat-saturated T1-weighted MR image shows minor eccentric contrast enhancement.
D, No significant contrast material flow was seen within the lesion on MR digital subtraction angiograms. This lesion was diagnosed as Burkitt lymphoma on the basis of biopsy findings.
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AJNR - American Journal of Neuroradiology