Role of Non invasive Imaging in Characterisation of Soft Tissue Vascular Anomalies: Comparison of Ultrasound with Contrast Enhanced Magnetic Resonance Imaging
Introduction: Soft tissue vascular anomalies present a diagnostic challenge. In these anomalies, imaging is crucial for therapeutic planning and improvement of prognosis. Ultrasound (US) and Contrast-Enhanced Magnetic Resonance Imaging (CEMRI) are both widely utilised and are valuable imaging mo...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2020-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/14022/45475_CE[Ra1]_F(SL)_PF1(AB_SL)_PFA(SL)_PN(SL).pdf |
| Summary: | Introduction: Soft tissue vascular anomalies present a diagnostic
challenge. In these anomalies, imaging is crucial for therapeutic
planning and improvement of prognosis. Ultrasound (US) and
Contrast-Enhanced Magnetic Resonance Imaging (CEMRI) are both
widely utilised and are valuable imaging modalities, both having
distinct advantages and limitations in evaluation of such lesions.
Aim: To evaluate soft tissue vascular anomalies using US and CEMRI
and assess their agreement in characterisation of these lesions.
Materials and Methods: The prospective study included 75
patients with vascular anomalies evaluated by means of US and
CEMRI: 71 underwent both US and MRI, three underwent US
alone, and one patient underwent MRI alone. Patients of all ages
were included. Lesions were characterised based on imaging
findings and vascular perfusion characteristics. Histopathological
evaluation was done in all patients. Receiver Operating
Characteristic (ROC) analysis was used for differentiating data.
The agreement of US and CEMRI with histopathological diagnosis
were assessed using kappa statistics.
Results: Among the soft tissue vascular anomalies, 17 were
haemangiomas, 55 were vascular malformations and 3 were
other vascular tumours. Majority of the lesions were venous
malformations (n=26; 34.66%). A cut-off value of 17.5 cm/sec
of peak venous velocity using Colour Doppler showed 100%
sensitivity in differentiating Arterio-Venous Malformations (AVM)
from haemangiomas using ROC curves. Agreement expressed
as kappa was 0.884 (95% CI 0.794-0.973) for US and 0.923
(95% CI 0.850-0.996) for CEMRI demonstrating near perfect
agreement with histopathology in both.
Conclusion: The findings of this study indicate that both US
and CEMRI are accurate in detection and characterisation
of soft tissue vascular anomalies showing comparable level
of agreement. US may be the preferred imaging modality as
it is widely available, relatively inexpensive and non invasive.
Contrast enhanced MRI may be reserved as a complementary
technique in cases wherein lesion categorisation or extent is
ambiguous during diagnosis. |
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| ISSN: | 2249-782X 0973-709X |