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, 31 (4), 569-75

Imaging Strategies in Intramuscular Haemangiomas: An Analysis of 20 Cases

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Imaging Strategies in Intramuscular Haemangiomas: An Analysis of 20 Cases

Jia-Lin Wu et al. Int Orthop.

Abstract

The purpose of this study was to review the correlation between the imaging studies and the histological findings in the diagnosis of this disease. We retrospectively reviewed 21 lesions in 20 patients (median age, 23.7 years old) who had been diagnosed with cavernous haemangiomas (n=11), capillary (n=6), and mixed (n=3) types. The imaging studies were obtained with plain film radiography (n=20), Tc-99 m bone scans (n=5), angiography (n=7) and magnetic resonance imaging (MRI; n=20). All the patients underwent marginal to wide excision. Based on the imaging studies, the rate of accurate prediction of intramuscular haemangioma using MRI in our study was 90%. Using the preoperative imaging studies and surgical excisions, only one (5%) local recurrence happened 2 years after marginal excision. The remaining patients were free of disease. For the avoidance of recurrence, wide excision is necessary with the help of the imaging studies, which can provide more specific information, making possible the preoperative identification of characteristic features of the tumuor.

Figures

Fig. 1
Fig. 1
Case no. 4: a 41-year-old woman with cavernous haemangioma in her left forearm. Lateral radiograph (a) shows pronounced soft tissue swelling of the forearm with multifoci of phleboliths and calcifications. Axial T1-weighted (b) spin-echo MR image shows an infiltrative mass (arrows) of intermediate signal intensity within the muscles. Note atrophy and fatty infiltration of the involved muscles. Axial fat-suppressed T2-weighted (c) fast-spin-echo MR image shows a lobulated-like mass (arrows) of high signal intensity infiltrating the muscles. Axial contrast-enhanced T1-weighted (d) spin-echo MR image shows enhancement of the lesion (arrows)
Fig. 2
Fig. 2
Case no. 1: a 12-year-old boy with mixed-type intramuscular hemangioma in his right calf. The boy had a history of contusion about 1 month before. The plain film shows soft tissue swelling and intramuscular fatty streaks (arrows). Haematoma could not be ruled out. The arteriogram shows enlarged and tortuous anterior and posterior tibial arteries

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