Clinical Application of Color Doppler Ultrasound in Evaluation of Vascular Lesions and Treatment of Hemangiomas

Kim, Young Hun; Oh, Jong Young; Song, Ki Hoon; Kim, Ki Ho

Abstract

Hemangioma is the most common tumor occuring in infancy as a well-circumscribed, strawberry-like mass. Hemangiomas evolve in three phases ; postnatal endothelial proliferation (about 12 months), variable stability, and slow involution(around 18 months to 10 years). In most instances, the diagnosis of common hemangioma can be established on the basis of the history and physical examination. Ultrasound, when combined with color doppler imaging and doppler spectral analysis of vascular channels, can be so much useful to predict the exact nature of tissue content and the characteristics of vascular flow in hemangiomas. This technique has many advantages such as non-invasiveness, relatively low cost, no need for heavy sedation. Doppler ultrasound can reflect the changes in echogenecities and flow patterns according to the respective evolutional phases of hemangiomas. Color doppler ultrasound were performed to 20 infants and children with clinical hemangiomas. We investigated the peak systolic velocity(PSV) and resistive index(RI) of feeder arteries in hemangiomatous lesions. PSVs and RIs showed differences in their mean values between the patients under 1 year old and those older than 1 year old of age. The compression therapy and/or oral steroid therapy were applied to 10 patients, who showed high PSVs and low RIs, on the purpose of reducing in-flow. After at least 6 months' treatment, we noticed the decreased PSVs together with increased RIs in 7 patients showing clinical improvement. Color doppler ultrasound should be one of the optional imaging modalities for various items; assessment of evolutional phases in hemangiomas, decision of treatment modalities and evaluation of treatment effects to hemangiomas.