Facial vascular anomalies; MRI and TRICKS-MR angiography diagnostic approach

• Published in: Egyptian journal of radiology and nuclear medicine Vol. 48; no. 4; pp. 885 - 895
• Main Authors: Hassanien, Omar A., Ghieda, Usama E., Younes, Rasha L., Shaban, Ekhlas A.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01-12-2017; SpringerOpen
• Subjects: Facial; MRI MRA TRICKS; Vascular anmolaies; Facial; Vascular anmolaies; MRI MRA TRICKS
• ISSN: 0378-603X
• DOI: 10.1016/j.ejrnm.2017.08.013

Evaluate role of MRI and TRICKS-MR angiography in diagnosis of facial vascular anomalies.
This study included 22 patients (mean age 9 years) with proved facial vascular anomalies on basis of interventional/surgical procedures (n = 19) or clinical follow up (n = 3). They underwent MRI examination with TRICKS-MRA. Images were evaluated for lesion location, size, feeding arteries and draining veins.
AVM was diagnosed in 15 patients (68.2%), hemangioma (5) patients (27.7%) and low flow venous malformation (2) patients (9.1%). TRICKS-MRA was accurate in diagnosis of 25 feeding arteries out of total 27 included in the study with 92.6% positive predictive value, 100% negative predictive value and 93.1% accuracy. AVMs were treated with sclerotherapy (26.7%), embolization (40%) and combined embolization and surgery (33.3%). Surgery was done in 2 hemangiomas (40%) while the other three patients (60%) underwent clinical follow up for 2 years with stationary course. The 2 patients with venous malformation underwent successful sclerotherapy.
MRI & TRICKS-MRA provide excellent diagnostic data for assessment of facial vascular anomalies. TRICKS -MRA adds precise delineation of the vascular mapping, regarding feeding arteries and draining veins which helps in planning of therapeutic approach and reduces needing for invasive DSA.