Lymphovascular malformations, imaging spectrum on USG and CT (with emphasis on intralesional haemorrhage) - A descriptive study

Abstract

Introduction- Lymph vascular/lymphatic malformations usually affect infants or children. Most common sites are the head and neck. When, superficial, they present with growing swelling in affected part. Their preoperative evaluation is necessary for better postoperative outcome and to reduce the chances of recurrence. Ultrasound is the useful modality to depict the exact location and character of lesion. Colour Doppler demonstrates vascular nature of lesions. CECT providing three dimensional views of lesion as well as insinuation/extension in adjacent structures, ensuring complete surgical removal of lesion and better postoperative outcome. Method –We studied imaging spectrum of LVMs (lymphovascular malformations) in USG and colour Doppler in 40 patients at Gandhi medical college Bhopal.29 patients have further undergone CECT for better depiction of lesion. We noted imaging spectrum of lesions on USG and CECT. Results-Most patients presenting with growing/congenital swelling were infants. Most common finding in USG was complex multisptated cystic lesion showing intraseptal vascularity on Doppler CECT demonstrated multiseptated cystic lesion with peripheral and septal enhancement. Most of them were fluid density lesion and showing insinuation in adjacent structure.18 patients were confirmed on FNAC and 22 patients were confirmed on surgery. Conclusion-USG is best mean to describe the character and location of lesion, also widely available, easy to use and suitable for infants and children (no sedation required). Many cases require further imaging with CECT, for further characterization of lesion and to evaluate their extension/insinuation. Surgical removal is final treatment keeping the incidences of recurrences low.