“Facial vascular anomalies; MRI and TRICKS-MR angiography diagnostic approach”

Abstract

Purpose: Evaluate role of MRI and TRICKS-MR angiography in diagnosis of facial vascular anomalies. Material and methods: This study included 22 patients (mean age 9 years) with proved facial vascular anomalies on basis of interventional/surgical procedures (n = 19) or clinical follow up (n = 3). They underwent MRI examination with TRICKS-MRA. Images were evaluated for lesion location, size, feeding arteries and draining veins. Results: AVM was diagnosed in 15 patients (68.2%), hemangioma (5) patients (27.7%) and low flow venous malformation (2) patients (9.1%). TRICKS-MRA was accurate in diagnosis of 25 feeding arteries out of total 27 included in the study with 92.6% positive predictive value, 100% negative predictive value and 93.1% accuracy. AVMs were treated with sclerotherapy (26.7%), embolization (40%) and combined embolization and surgery (33.3%). Surgery was done in 2 hemangiomas (40%) while the other three patients (60%) underwent clinical follow up for 2 years with stationary course. The 2 patients with venous malformation underwent successful sclerotherapy. Conclusion: MRI & TRICKS-MRA provide excellent diagnostic data for assessment of facial vascular anomalies. TRICKS -MRA adds precise delineation of the vascular mapping, regarding feeding arteries and draining veins which helps in planning of therapeutic approach and reduces needing for invasive DSA