ПРОМЕНЕВІ МЕТОДИ ВІЗУАЛІЗАЦІЇ СУДИННИХ АНОМАЛІЙ У ДІТЕЙ

Background. Clinical diagnosis of vascular anomalies is often dif ficult. The informative of dif ferent instrumental evaluations isn’t the same in terms of visualization of vascular anomalies. Purpose: to establish the diagnostic value and informative of different visualization’s methods of vascular anomalies in children. Methods. The study included 194 patients with vascular anomalies in age from 1 month to 16 years. According to the updated ISSVA classification 2014, vascular anomalies divided into vascular tumors and vascular malformations (VMs). Vascular tumors are diagnosed in 95 patients, in particular, infantile hemangiomas (IHs) of soft tissues (80.0%), liver hemangiomas (5.3%), airways IHs (5.3%), IHs as a part of PHACE syndrome (2.1%). Rare vascular tumors were in 7 (7.3%) patients. In 99 patients VMs diagnosed: lymphatic malformations (LM) in 86.8%, venous malformations in 8.1%, and combined VMs in 5.1% of children. Results. Ultrasound examinations performed as a primary method and follow-up studies. The activity of His was determined by the ratio of small diameter vessels and solid tissue. CT with contrast enhanced and MRI performed in 5.3% patients with IHs of soft tissue with atypical clinical presentations and in patients with airway His (9.3%). To confirm the diagnosis of the liver hemangiomas the CT with contrast enhanced performed. In 4.4% patients with well localized cystic LM performed ultrasound only, all other patients underwent MRI. CT scans performed in 10.2% children with LM of head and neck and symptoms of airway compression as emergency diagnostic procedure. The peculiarity of VM is phleboliths formation. It can be detected as ultrasound, so X-ray examination but to determine the distribution of process is the most informative is MRI. Arteriovenous malformation in CDS scale has the same characteristic as the IHs in proliferative phase. So if these features are revealed in older children CT with contrast enhanced is necessary . Conclusions. For the diagnosis of vascular anomalies the primary investigation is ultrasound examination. The “gold standard” for diagnosis of slow-flow VM is the MRI. For the diagnosis of high flow VM informative is the CT scan with contrast enhanced.