Spectral Doppler ultrasound for predicting long-term response to topical timolol in children with infantile hemangioma.

Abstract

To assess the utility of color and spectral Doppler ultrasound at predicting infantile hemangioma (IH) response to timolol. Eighty-three children (0-6 months old) with IH were treated with topical 0.5% timolol maleate twice daily for 6 months. They underwent color and spectral Doppler sonographic examinations at the first visit and 1 month after beginning timolol. Hemangioma volume, arterial diameter (AD), venous diameter (VD), resistance index (RI), pulsatility index (PI), peak arterial systolic velocity (PASV), maximum venous velocity, and mean venous velocity were measured. Therapeutic outcome was assessed at 6 months. The hemangiomas were classified as deep (55.4%), hybrid (28.9%), or superficial (15.7%) and were located in the head and neck (36.1%), limbs (21.7%), or torso (42.2%). Regression occurred in 53 patients (63.9%). Timolol was the most effective in patients aged 5-6 months, in superficial hemangiomas, and in hemangiomas located on the torso. Receiver operating characteristic analysis revealed that changes in RI (sensitivity/specificity: 71.7%/96.7%), PI (sensitivity/specificity: 73.6%/86.7%), PASV (sensitivity/specificity: 81.1%/80.0%), change in arterial diameter (sensitivity/specificity: 58.5%/83.3%), and change in venous diameter (sensitivity/specificity: 62.3%/73.3%) at 1 month could predict response to timolol at 6 months. Changes in AD, VD, RI, PI, and PASV at 1 month could be used to predict response to timolol at 6 months. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:480-487, 2017.