• MRI Findings Common to Infantile Hemangiomas

      Patel, Nirav; The University of Arizona College of Medicine - Phoenix; O'Haver, Judith; Price, Harper; Towbin, Richard (The University of Arizona., 2012-05-02)
      Background: Infantile hemangiomas (IH) are the most common vascular tumors of infancy. Children may have Magnetic Resonance Imaging (MRI) to establish or confirm the diagnosis or to further evaluate lesions that do not improve with treatment. Objective: Describe specific MRI findings common to infantile hemangiomas. Compare the imaging diagnosis with the clinical diagnosis of IH to determine diagnostic accuracy. Methods: A descriptive retrospective chart review on a convenience sample. Twenty-six patients had a total of 31 MR studies in the group. From these 31 studies, 16 also had magnetic resonance angiography (MRA). Results: Clinical diagnosis matched imaging diagnosis 96.8% of the time. Findings from imaging of the infantile hemangiomas included increased signal intensity on T2-weighted sequences (96.8%), isointense or decreased signal with T1-weighted sequences (83.9%) and moderate to marked contrast enhancement (78.5%). Lesions appeared to be high flow (64.5%), demonstrated lobulation (58.1%), and displayed central, low signal intensity dots on T2-weighted sequences (54.8%). In contrast, cystic spaces, intralesional DIC, phleboliths, focal intralesional inhomogenities, septation, edema, fat stranding, aneurysms, venous ectasia, and shunts were not features regularly seen in imaging of IHs in this study. Limitations: Small sample size on a convenience sample based at one institution. Conclusion: There are specific features to infantile hemangiomas on MR imaging that can be used for aid in diagnosis.
    • Three Cases in Pediatric Neuroradiology: Athabascan Brainstem Dysgenesis Syndrome, Aicardi Goutières Syndrome, and Aplasia of the Parotid Glands

      Higley, Meghan; The University of Arizona College of Medicine - Phoenix; Towbin, Richard (The University of Arizona., 2012-04-30)
      Summary: The human HOXA1 mutation syndromes commonly present with abnormalities of the inner ear and internal carotid arteries. Previous cases describe varying degrees of hypoplasia or aplasia of the affected structures, often with asymmetrical involvement. We present imaging findings documenting complete absence of the internal carotid arteries bilaterally with bilateral Michel aplasia of the inner ear, which, to our knowledge, has not been previously reported. Based on the number of cases identified and birth rates within studied populations, we estimated the incidence of ABDS at 0.5-1:1000 live births on the White River Apache Reservation and 1:3000 live births in the Navajo population. If accurate, this suggests a carrier frequency similar to that for cystic fibrosis in Caucasian populations. ABDS may represent a significantly underrecognized disorder among Athabaskan Native Americans, raising questions of the possible benefit of genetic counseling for affected families. However, cultural considerations in this population bring into question the possible conflict between counseling based on gene theory and traditional beliefs.