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Título

Vascular Anomalies In Head And Neck: A Pictorial Essay

Introdução e objetivo(s)

Vascular anomalies (VA) are a heterogeneous group of vascular pathologies resulting from errors during embryogenesis, involving abnormal processes in apoptosis, vascular cell maturation and growth. The accurate characterization of these lesions is challenging due to their immense phenotypic variability, but precise diagnosis is essential for therapeutic success. The aim of this work is to illustrate the main radiological presentations of VA in the head and neck and some of their differential diagnoses.

Método(s)

Pictorial essay with magnetic resonance imaging (MRI) images from the imaging department, demonstrating cases of VA in the head and neck and their main differential diagnoses, presented in a didactic way.

Discussão

According to the International Society for the Study of Vascular Anomalies (ISSVA), VA are classified as vascular tumors and vascular malformations. Vascular tumors are a result of endothelial cell proliferation and can be benign (e.g., hemangiomas), locally aggressive (e.g., kaposiform hemangioendothelioma), and malignant (e.g., angiosarcoma). Vascular malformations, on the other hand, are structural vascular anomalies resulting from angiogenesis failure, further divided into simple, combined, of major named vessels and associated with other abnormalities. The simple ones are classified into capillary, venous, lymphatic, arteriovenous, and arteriovenous fistulas, which may be merged in the same lesion. Concerning the areas of Head and Neck, precise diagnosis is even more important, as VA significantly contribute to aesthetic and functional impairments. It is necessary to differentiate them from other lesions commonly found in the same topography, such as pleomorphic adenoma, schwannoma, paraganglioma, sarcomas, and currently, procedures related to facial harmonization. Therefore, MRI is indispensable for defining the diagnosis, confirming specific lesion attributes, establishing locations, setting anatomical limits, measuring extent and planning potential surgical interventions.

Conclusões

Radiologists have a fundamental role in defining precise diagnosis in head and neck VA through exams such as angiography, ultrasonography, and specially, magnetic resonance imaging. MRI represents the main diagnostic method, establishing characteristics of the lesion and anatomical limits, which will impact the choice of therapy and, consequently, the quality of patients’ life.

Palavras Chave

Magnetic Resonance Imaging; vascular assessment

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