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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleHEAD AND NECK

Pediatric Head and Neck Lesions: Assessment of Vascularity by MR Digital Subtraction Angiography

Weng Kong Chooi, Neil Woodhouse, Stuart C. Coley and Paul D. Griffiths
American Journal of Neuroradiology August 2004, 25 (7) 1251-1255;
Weng Kong Chooi
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Neil Woodhouse
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Stuart C. Coley
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Paul D. Griffiths
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  • Fig 1.
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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.

  • Fig 2.
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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.

Tables

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  • Clinical details and MR imaging findings

    Case No.Sex, AgeClinical DetailsConventional MR Imaging FindingsMR-DSA VascularityFinal Diagnosis
    1 (Fig. 1)F, 3 yr*Scalp mass, indeterminate vascularityEnhancing soft tissue mass with flow voidHighExtracranial AVM
    2 (Fig. 2)F, 14 moNeck swelling, indeterminate vascularityEnhancing soft tissue mass with flow voidsHighHemangioma (proliferative phase)
    3 (Fig. 3)F, 1 wkLarge occipital mass, presumed occipital encephaloceleEnhancing heterogeneous extra-calvarial massHighUndifferentiated highly vascular tumor (+)
    4F, 2 yr*Eyelid mass, ?dermoid, ?encephaloceleEnhancing mass with flow voidsHighAVM
    5M, 15 moEyelid hemangiomaEnhancing rounded eyelid mass, no flow voidsHighAVM
    6 (Fig. 4)M, 5 yr*Nasopharyngeal massHeterogeneous mass with minor enhancementLowBurkitt lymphoma (+)
    7F, 2 d*Large palatal massLarge enhancing tumorHighCystic teratoma (+)
    8F, 16 yrSturge-Weber syndrome, ?ocular angiomaChoroidal thickening with enhancementLowDiffuse choroidal angioma plus detachment
    9M, 2 yr*Eyelid hemangiomaEnhancing soft tissue mass, no flow voidsLowHemangioma
    10F, 3 yr*Scalp lesionEnhancing soft tissue mass, no flow voidsLowVenous malformation
    11M, 10 yr*?VI naevus flammeus, ?Sturge-Weber syndromeChoroidal thickening with enhancementLowDiffuse choroidal angioma
    12M, 12 yr*Known cervical osteochondromaDisplacement but no invasion of the vertebral artery by bony tumorLowOsteochondroma with no vascular invasion (+)
    • Note.—DSA indicates digital subtraction angiography; F, female; M, male; AVM, arteriovenous malformation; (+), histologic confirmation; ?, possible.

    • * MR imaging examinations performed with the patient under general anesthesia.

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American Journal of Neuroradiology: 25 (7)
American Journal of Neuroradiology
Vol. 25, Issue 7
1 Aug 2004
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Cite this article
Weng Kong Chooi, Neil Woodhouse, Stuart C. Coley, Paul D. Griffiths
Pediatric Head and Neck Lesions: Assessment of Vascularity by MR Digital Subtraction Angiography
American Journal of Neuroradiology Aug 2004, 25 (7) 1251-1255;

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Pediatric Head and Neck Lesions: Assessment of Vascularity by MR Digital Subtraction Angiography
Weng Kong Chooi, Neil Woodhouse, Stuart C. Coley, Paul D. Griffiths
American Journal of Neuroradiology Aug 2004, 25 (7) 1251-1255;
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