Skip to main content
Top
Published in: Skeletal Radiology 10/2008

01-10-2008 | Scientific Article

Venous malformations: MR imaging features that predict skin burns after percutaneous alcohol embolization procedures

Authors: Laura M. Fayad, Tuncay Hazirolan, John A. Carrino, David A. Bluemke, Sally Mitchell

Published in: Skeletal Radiology | Issue 10/2008

Login to get access

Abstract

Objective

To examine the value of magnetic resonance (MR) imaging for predicting the occurrence of skin burns in patients with venous malformations who undergo percutaneous alcohol embolization was the objective of the study.

Materials and methods

Pre-procedural MR imaging at 1.5 T from 40 patients with venous malformations who had undergone percutaneous alcohol embolization was retrospectively reviewed by two observers for these features: anatomic location, definition (well-defined or ill-defined), and the presence of skin, subcutaneous tissue, muscle, tendon, bone, joint, and deep venous system involvement. One observer recorded the length of skin involvement and volume of the malformation. Univariate and multivariate analysis tests were used to determine whether an association between the occurrence of skin burns and MR imaging features existed.

Results

The anatomic locations of the venous malformations were the lower extremity (20 out of 40), upper extremity (11 out of 40), trunk (four out of 40), head/neck (three out of 40) and pelvis (two out of 40). Of the 40 subjects, 15% (six out of 40) experienced skin burns. There was a significant association between the absence of muscle involvement (p = 0.0198) as well as the length of skin involvement (p = 0.027), with the occurrence of skin burns. Malformation size and all other features were not significantly associated with skin burns.

Conclusion

Skin burns in patients with venous malformations treated with alcohol embolization are associated with the length of skin involvement and with the absence of deeper tissue involvement, as depicted on MR imaging.
Literature
1.
go back to reference Laor T, Burrows PE. Congenital anomalies and vascular birthmarks of the lower extremity. Magn Reson Imag Clin North Am 1998;6: 497–519. Laor T, Burrows PE. Congenital anomalies and vascular birthmarks of the lower extremity. Magn Reson Imag Clin North Am 1998;6: 497–519.
2.
go back to reference Breugem CC, Maas M, Reekers JA, Van der Horst CMA. Use of magnetic resonance imaging for the evaluation of vascular malformations of the lower extremity. Plast and Reconstr Surg 2001;108: 870–877.CrossRef Breugem CC, Maas M, Reekers JA, Van der Horst CMA. Use of magnetic resonance imaging for the evaluation of vascular malformations of the lower extremity. Plast and Reconstr Surg 2001;108: 870–877.CrossRef
3.
go back to reference Eifert S, Villavicencio JL, Kao TC, Taute BM, Rich NM. Prevalence of deep venous anomalies in congenital vascular malformations of venous predominance. J Vasc Surg 2000;31: 562–471.CrossRef Eifert S, Villavicencio JL, Kao TC, Taute BM, Rich NM. Prevalence of deep venous anomalies in congenital vascular malformations of venous predominance. J Vasc Surg 2000;31: 562–471.CrossRef
4.
go back to reference Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 1982;69: 412–420.PubMedCrossRef Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 1982;69: 412–420.PubMedCrossRef
5.
go back to reference Finn MC, Glowacki J, Mulliken JB. Congenital vascular lesions: clinical application of a new classification. J Pediatr Surg 1983;18: 894–899.PubMedCrossRef Finn MC, Glowacki J, Mulliken JB. Congenital vascular lesions: clinical application of a new classification. J Pediatr Surg 1983;18: 894–899.PubMedCrossRef
6.
go back to reference Upton J, Mulliken JB, Murray EJ. Classification and rationale for management of vascular anomalies in the upper extremity. J Hand Surg 1985;6: 970–975. Upton J, Mulliken JB, Murray EJ. Classification and rationale for management of vascular anomalies in the upper extremity. J Hand Surg 1985;6: 970–975.
7.
8.
go back to reference Claudon M, Upton J, Burrows PE. Diffuse venous malformations of the upper limb: morphologic characterization by MRI and venography. Pediatr Radiol 2001;31: 507–514.PubMedCrossRef Claudon M, Upton J, Burrows PE. Diffuse venous malformations of the upper limb: morphologic characterization by MRI and venography. Pediatr Radiol 2001;31: 507–514.PubMedCrossRef
9.
go back to reference Hein KD, Mulliken JB, Kozakewich HPW, Upton J, Burrows PE. Venous malformations of skeletal muscle. Plast and Reconstr Surg 2002;110: 1625–1635.CrossRef Hein KD, Mulliken JB, Kozakewich HPW, Upton J, Burrows PE. Venous malformations of skeletal muscle. Plast and Reconstr Surg 2002;110: 1625–1635.CrossRef
10.
go back to reference Fayad LM, Hazirolan T, Bluemke DA, Mitchell S. Vascular malformations in the extremities: emphasis on imaging features that guide treatment options. Skeletal Radiol 2006;35: 127–137.PubMedCrossRef Fayad LM, Hazirolan T, Bluemke DA, Mitchell S. Vascular malformations in the extremities: emphasis on imaging features that guide treatment options. Skeletal Radiol 2006;35: 127–137.PubMedCrossRef
11.
go back to reference Lee BB, Bergan JJ. Advanced management of congenital vascular malformations: a multidisciplinary approach. Cardiovasc Surg 2002;10: 523–533.PubMedCrossRef Lee BB, Bergan JJ. Advanced management of congenital vascular malformations: a multidisciplinary approach. Cardiovasc Surg 2002;10: 523–533.PubMedCrossRef
12.
go back to reference Dobson MJ, Hartley RWJ, Ashleigh R, Watson Y, Hawnaur JM. MR angiography and MR imaging of symptomatic vascular malformations. Clin Radiol 1997;52: 595–602. 13.PubMedCrossRef Dobson MJ, Hartley RWJ, Ashleigh R, Watson Y, Hawnaur JM. MR angiography and MR imaging of symptomatic vascular malformations. Clin Radiol 1997;52: 595–602. 13.PubMedCrossRef
13.
go back to reference Rak KM, Yakes WF, Ray RL, et al. MR imaging of symptomatic peripheral vascular malformations. AJR Am J Roentgenol 1992;159: 107–112.PubMed Rak KM, Yakes WF, Ray RL, et al. MR imaging of symptomatic peripheral vascular malformations. AJR Am J Roentgenol 1992;159: 107–112.PubMed
14.
go back to reference Rinker B, Karp NS, Margiotta M, Blei F, Rosen R, Rofsky NM. The role of magnetic resonance imaging in the management of vascular malformations of the trunk and extremities. Plast Reconstr Surg 2003;112: 504–510.PubMedCrossRef Rinker B, Karp NS, Margiotta M, Blei F, Rosen R, Rofsky NM. The role of magnetic resonance imaging in the management of vascular malformations of the trunk and extremities. Plast Reconstr Surg 2003;112: 504–510.PubMedCrossRef
15.
go back to reference Puig S, Casati B, Staudenherz A, Paya K. Vascular low-flow malformations in children: current concepts for classification, diagnosis and therapy. Eur J Radiol 2005;53: 35–45.PubMedCrossRef Puig S, Casati B, Staudenherz A, Paya K. Vascular low-flow malformations in children: current concepts for classification, diagnosis and therapy. Eur J Radiol 2005;53: 35–45.PubMedCrossRef
16.
go back to reference Koenig TR, Wolff D, Mettler FA, Wagner LK. Skin injuries from fluoroscopically guided procedures: part 1, characteristics of radiation injury. AJR Am J Roentgenol 2001;177: 3–11.PubMed Koenig TR, Wolff D, Mettler FA, Wagner LK. Skin injuries from fluoroscopically guided procedures: part 1, characteristics of radiation injury. AJR Am J Roentgenol 2001;177: 3–11.PubMed
Metadata
Title
Venous malformations: MR imaging features that predict skin burns after percutaneous alcohol embolization procedures
Authors
Laura M. Fayad
Tuncay Hazirolan
John A. Carrino
David A. Bluemke
Sally Mitchell
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
Skeletal Radiology / Issue 10/2008
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-008-0534-4

Other articles of this Issue 10/2008

Skeletal Radiology 10/2008 Go to the issue