Introduction

Congenital vascular malformations represent an important group of pediatric diseases. The clinical importance of vascular anomalies ranges from uncomplicated and asymptomatic alterations such as hemangiomas of the skin which have only esthetic

Mra Pelvis For Hermangioma

Fig. 1. MIP reconstruction of a 3D CE MRA dataset of the distal aorta and iliac arteries (Gd-BOPTA, 0.1 mmol/kg). Preoperative evaluation of a 14 year old female patient referred for surgery of the urinary bladder revealed an unclear vascular malformation of the pelvic vessels. The MIP image shows that the right common iliac artery derives blood from an atypical vessel originating from the left common iliac artery at the origin of the internal left iliac artery. This atypical vessel crosses the pelvis dorsal to the urinary bladder and supplies the right lower extremity (arrows)

Fig. 1. MIP reconstruction of a 3D CE MRA dataset of the distal aorta and iliac arteries (Gd-BOPTA, 0.1 mmol/kg). Preoperative evaluation of a 14 year old female patient referred for surgery of the urinary bladder revealed an unclear vascular malformation of the pelvic vessels. The MIP image shows that the right common iliac artery derives blood from an atypical vessel originating from the left common iliac artery at the origin of the internal left iliac artery. This atypical vessel crosses the pelvis dorsal to the urinary bladder and supplies the right lower extremity (arrows)

therapeutic consequences, up to life threatening pathologies such as anomalies of the great vessels or large angiomatoid tumors manifesting with hy-poxia due to compression of the airways or because of inadequate oxygen saturation due to right-to-left shunting.

Most of the vascular malformations arise between the third and seventh weeks of embryonic development and may affect the arterial or venous blood vessels, capillaries, lymphatic vessels or venous sinuses. Typically most of the clinically relevant malformations are found in the thorax, however sometimes they also may be incidental findings in other areas (Fig. 1). Malformations may present as changes of the size or course of vessels or as alterations of the vessel wall anatomy. Some malformations involve only an isolated vessel or parts of a vessel, while others may affect a larger part of the vascular system [ 1 ].

Vascular malformations, due to the diversity of their clinical manifestations and resulting therapeutic consequences, require an adequate diagnostic tool. MR imaging with its high spatial resolution, free choice of image orientation and lack of ionising radiation is increasingly considered the imaging modality of choice, especially in newborn or small children. A recent study has shown that MRA of the pulmonary vessels in children is superior to echocardiography [2]. Specifically, MRA may clarify uncertain diagnoses in up to one third of the patient population, and reveal an additional diagnosis in another third.

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