Color Doppler Evaluation of Arterial Resistive Index in Infantile Hemangioma: A Useful Parameter to Monitor the Response to Oral Propranolol?

Infantile hemangioma (IH) is the most common benign vascular tumor in childhood. In more than 85% of all cases, IHs undergo spontaneous involution, but nearly 10–12% of IHs develop complications and require immediate therapy. Oral propranolol is currently the first-line treatment for IHs. Color Dopp...

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Main Authors: George Koshy Parapatt, Teresa Oranges, Guglielmo Paolantonio, Lucilla Ravà, Simona Giancristoforo, Andrea Diociaiuti, May El Hachem, Massimo Rollo
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-12-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2021.718135/full
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author George Koshy Parapatt
Teresa Oranges
Guglielmo Paolantonio
Lucilla Ravà
Simona Giancristoforo
Andrea Diociaiuti
May El Hachem
Massimo Rollo
author_facet George Koshy Parapatt
Teresa Oranges
Guglielmo Paolantonio
Lucilla Ravà
Simona Giancristoforo
Andrea Diociaiuti
May El Hachem
Massimo Rollo
author_sort George Koshy Parapatt
collection DOAJ
description Infantile hemangioma (IH) is the most common benign vascular tumor in childhood. In more than 85% of all cases, IHs undergo spontaneous involution, but nearly 10–12% of IHs develop complications and require immediate therapy. Oral propranolol is currently the first-line treatment for IHs. Color Doppler ultrasound is the gold standard in the diagnosis of deep IH, and it is used to evaluate the morphological change and the modification of vascularization that occur during its evolution and treatment. To date, only few data in the literature described the changes of intralesional arterial resistive index (RI) during treatment with propranolol; particularly, some authors have shown an increase of intralesional arterial RI in IHs with clinical regression during treatment with propranolol. The objective of this paper is to evaluate the changes of RI of the intralesional arteries of the IHs during the treatment with oral propranolol. We retrospectively analyzed a total of 64 IHs in 60 patients treated with oral propranolol with a good clinical response. Gray-scale ultrasonography and color Doppler imaging were performed before and during the therapy. The intralesional RIs were measured before and during the treatment. For each lesion, we recorded the RI values, and then we calculated the mean RI value for any single lesion. We compared the mean RI value observed at the baseline with the mean RI value of the last detectable sampling at color Doppler. We also compared between them the mean RI values observed during intermediate ultrasound. The RI values were compared in 44 lesions, with at least two significant samplings of RI. In the 44 lesions compared, we did not find statistically significant variations in the mean RI values between the baseline control and the values recorded at the last post-treatment control. The time trend of mean RI values of the intermediate color Doppler analysis performed between the first pre-treatment control and the last measurable control did not show any statistically significant variation in the trend of mean RI values. Contrarily to what has been described by some authors, in our experience, we have not observed an increase of RI in IHs treated with oral propranolol.
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spelling doaj.art-d23cc8b965ee47158a4aa2f916fe353d2022-12-21T23:11:44ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-12-01910.3389/fped.2021.718135718135Color Doppler Evaluation of Arterial Resistive Index in Infantile Hemangioma: A Useful Parameter to Monitor the Response to Oral Propranolol?George Koshy Parapatt0Teresa Oranges1Guglielmo Paolantonio2Lucilla Ravà3Simona Giancristoforo4Andrea Diociaiuti5May El Hachem6Massimo Rollo7Interventional Radiology Unit, Department of Imaging, Bambino Gesù Children Hospital (IRCCS), Rome, ItalyDermatology Unit, Department of Pediatrics, Meyer Children's Hospital, Florence, ItalyInterventional Radiology Unit, Department of Imaging, Bambino Gesù Children Hospital (IRCCS), Rome, ItalyUnit of Clinical Pathways and Epidemiology, Bambino Gesù Children Hospital (IRCCS), Rome, ItalyDermatology Unit and Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children Hospital (IRCCS), Rome, ItalyDermatology Unit and Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children Hospital (IRCCS), Rome, ItalyDermatology Unit and Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children Hospital (IRCCS), Rome, ItalyInterventional Radiology Unit, Department of Imaging, Bambino Gesù Children Hospital (IRCCS), Rome, ItalyInfantile hemangioma (IH) is the most common benign vascular tumor in childhood. In more than 85% of all cases, IHs undergo spontaneous involution, but nearly 10–12% of IHs develop complications and require immediate therapy. Oral propranolol is currently the first-line treatment for IHs. Color Doppler ultrasound is the gold standard in the diagnosis of deep IH, and it is used to evaluate the morphological change and the modification of vascularization that occur during its evolution and treatment. To date, only few data in the literature described the changes of intralesional arterial resistive index (RI) during treatment with propranolol; particularly, some authors have shown an increase of intralesional arterial RI in IHs with clinical regression during treatment with propranolol. The objective of this paper is to evaluate the changes of RI of the intralesional arteries of the IHs during the treatment with oral propranolol. We retrospectively analyzed a total of 64 IHs in 60 patients treated with oral propranolol with a good clinical response. Gray-scale ultrasonography and color Doppler imaging were performed before and during the therapy. The intralesional RIs were measured before and during the treatment. For each lesion, we recorded the RI values, and then we calculated the mean RI value for any single lesion. We compared the mean RI value observed at the baseline with the mean RI value of the last detectable sampling at color Doppler. We also compared between them the mean RI values observed during intermediate ultrasound. The RI values were compared in 44 lesions, with at least two significant samplings of RI. In the 44 lesions compared, we did not find statistically significant variations in the mean RI values between the baseline control and the values recorded at the last post-treatment control. The time trend of mean RI values of the intermediate color Doppler analysis performed between the first pre-treatment control and the last measurable control did not show any statistically significant variation in the trend of mean RI values. Contrarily to what has been described by some authors, in our experience, we have not observed an increase of RI in IHs treated with oral propranolol.https://www.frontiersin.org/articles/10.3389/fped.2021.718135/fullinfantile hemangioma (IH)resistive index (RI)color Doppleroral propranololultrasoundradiologic evaluation
spellingShingle George Koshy Parapatt
Teresa Oranges
Guglielmo Paolantonio
Lucilla Ravà
Simona Giancristoforo
Andrea Diociaiuti
May El Hachem
Massimo Rollo
Color Doppler Evaluation of Arterial Resistive Index in Infantile Hemangioma: A Useful Parameter to Monitor the Response to Oral Propranolol?
Frontiers in Pediatrics
infantile hemangioma (IH)
resistive index (RI)
color Doppler
oral propranolol
ultrasound
radiologic evaluation
title Color Doppler Evaluation of Arterial Resistive Index in Infantile Hemangioma: A Useful Parameter to Monitor the Response to Oral Propranolol?
title_full Color Doppler Evaluation of Arterial Resistive Index in Infantile Hemangioma: A Useful Parameter to Monitor the Response to Oral Propranolol?
title_fullStr Color Doppler Evaluation of Arterial Resistive Index in Infantile Hemangioma: A Useful Parameter to Monitor the Response to Oral Propranolol?
title_full_unstemmed Color Doppler Evaluation of Arterial Resistive Index in Infantile Hemangioma: A Useful Parameter to Monitor the Response to Oral Propranolol?
title_short Color Doppler Evaluation of Arterial Resistive Index in Infantile Hemangioma: A Useful Parameter to Monitor the Response to Oral Propranolol?
title_sort color doppler evaluation of arterial resistive index in infantile hemangioma a useful parameter to monitor the response to oral propranolol
topic infantile hemangioma (IH)
resistive index (RI)
color Doppler
oral propranolol
ultrasound
radiologic evaluation
url https://www.frontiersin.org/articles/10.3389/fped.2021.718135/full
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