MDCT angiography in evaluation of pediatric hemangiomas and peripheral vascular malformations

Background: To evaluate the role of MDCT angiography in peripheral hemangiomas and vascular malformations in pediatric patients.Methods: Total of 36 consecutive pediatric patients with clinically suspected peripheral hemangiomas and peripheral malformations were included in the study. MDCT angiography and doppler sonography was done for all patients. Final diagnosis was made by response to treatment and follow up. The statistical significance of various MDCT findings and post processing techniques was calculated. p value of <0.05 was considered significant.Results: Venous malformations were the most common. The MDCTA features which were significant in diagnosing venous malformations were phleboliths (p=0.039), peak enhancement in venous or delayed phase, absence of soft tissue mass, lacy tangle of vessels on maximum intensity projection and volume rendered images. Features significant in diagnosing arteriovenous malformations were tortuous arterial feeders, peak enhancement in arterial phase (0.0001), early draining vein (p=0.0001), venous phase wash out (p=0.0001), tense tangle of vessels on maximum intensity projection and volume rendered images (p=0.0003). Phleboliths (p=0.43) and venous or delayed phase peak enhancement (p=0.69) were overlapping features in congenital hemangiomas and venous malformations. Arterial phase enhancement (p=0.10) and early draining veins (p=0.39) were overlapping features in infantile proliferating hemangiomas and arteriovenous malformations. However, presence of soft tissue mass (p=0.0001) and lack of venous phase wash out (p=0.0003) were differentiating features for hemangiomas.Conclusions: MDCT angiography can be used as a highly accurate modality to diagnose hemangiomas and vascular malformations. It has an advantage over color Doppler in depicting entire extent of deep lesions

Isolated sternal hypoplasia: a rare cause of kyphoscoliosis

In most cases, kyphoscoliosis is idiopathic. However, this is a diagnosis of exclusion and can be made only if no cause can be identified. Kyphoscoliosis can occur due to various causes. Isolated sternal anomalies may also cause kyphoscoliosis secondary to the bony deformity though this has not previously been reported in literature. We have reported a case of kyphoscoliosis secondary to isolated sternal hypoplasia with complete absence of bony and cartilaginous elements of the body and xiphoid process of the sternum without any associated deformities of mediastinal structures, lung parenchyma or soft tissues in a young male patient. Careful evaluation of patients with kyphoscoliosis can ensure timely diagnosis of unusual and potentially treatable causes for the same such as sternal anomalies. Addition of lateral chest radiographs to the imaging protocol for evaluation of kyphoscoliosis can play a major role in timely diagnosis of such cases

Cystic masses of neck: A pictorial review

Cystic masses of neck consist of a variety of pathologic entities. The age of presentation and clinical examination narrow down the differential diagnosis; however, imaging is essential for accurate diagnosis and pretreatment planning. Ultrasound is often used for initial evaluation. Computed tomography (CT) provides additional information with regard to the extent and internal composition of the mass. Fine-needle aspiration cytology (FNAC) has a supplementary role for confirmation of diagnosis. Magnetic resonance imaging may be needed in some cases for preoperative assessment

Atypical lytic lesions of skull: Clinical and radiological correlation

Imaging alone cannot differentiate various isolated atypical lytic lesions involving the skull. Clinical and radiological correlation is mandatory in reaching to a diagnosis. Histopathology remains the gold standard. We describe few atypical cases presenting as isolated lytic lesions of skull with characteristic imaging findings and a brief clinical approach to reach towards the diagnosis

Giant aneurysm formation in sporadic renal angiomyolipoma

Angiomyolipomas are the most common mesenchymal renal neoplasms. Two types have been described: (i) sporadic angiomyolipoma and (ii) angiomyolipoma associated with tuberous sclerosis. Giant aneurysm formation is usually noted in angiomyolipomas associated with tuberous sclerosis and is rare in sporadic variety. Tumor diameter and aneurysm diameter have been used as predictors of rupture. We report a rare case of aneurysm formation in a sporadic angiomyolipoma

Imaging spectrum of neurofibromatosis

Neurofibromatosis (NF) belongs to the group of phakomatoses characterized by benign tumors of peripheral nerves seen either due to spontaneous new mutations or due to genetic inheritance. It affects 1:2500-3000 individuals. These tumors are known as neurofibromas and can be localized, the diffuse or plexiform type. There are at least eight subtypes of NF (NF-1-NF-8). Among these, von Recklinghausen′s disease (NF-1), NF with bilateral acoustic schwannomas (NF-2) and segmental NF important both clinically and radiologically

What clinician′s need to know about imaging features in lung cancer?

Bronchogenic carcinoma is one of the most common cancers both in males and females worldwide. Lung malignancies can present with manifestations involving any organ system and also mimic like benign nodules or infective consolidation. Present review highlights spectrum of typical presentations and imaging features of lung malignancies

Unusual imaging presentation of infantile atypical Kawasaki disease

Kawasaki disease is a systemic medium vessel vasculitis of unknown etiology affecting children under 5 years of age. There are no specific diagnostic tests, and thus, the diagnosis of the disease is primarily made on the basis of clinical criteria. Unusual presentations of Kawasaki disease have been variably reported from different parts of the world. However, presentation of the disease in the form of peripheral thromboembolism and florid non-coronary aneurysms has rarely been described This report describes the imaging findings in infantile atypical Kawasaki disease with aneurysms of multiple medium-sized arteries, including coronary arteries, emphasizing the detection of clinically silent aneurysms in the disease

Thymic masses: A radiological review

Various thymic masses and their normal variations have different pathological and management consequences. Radiologists and clinicians should be aware of these entities so that appropriate and timely treatment can be given