Pediatric Vascular Anomalies in a Specialized Interdisciplinary Center: A 10-Year Cohort Analysis of Diagnosis, Imaging, and Treatment Pathways

Vollständiger Abstract

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Abstract This study uses original data from a 10-year cohort analysis of diagnosis, imaging, and treatment pathways in pediatric vascular anomalies at a specialized interdisciplinary center. The study examines the role of radiology in establishing diagnostic and therapeutic algorithms for interdisciplinary management of children with vascular anomalies. A total of 331 children were included in this study. Patient characteristics, the location, and anatomical site of the vascular anomaly and associated pain levels were evaluated on a dedicated questionnaire. Diagnostic procedures (imaging, biopsies) and therapy recommendations (conventional compression therapy, anticoagulation, minimally invasive interventional procedures and surgery) were also analyzed. Variety and frequency of referral diagnosis and diagnostic imaging spectrum off-campus versus in house was evaluated with intermodal comparison. The patient population consisted of 52.3% females and 47.7% males with a median age of 9.08 years. Most frequent diagnosis was a venous malformation (45.32%), followed by hemangiomas (11.48%) or lymphatic malformations (9.06%). In 45.62% of patients, the referral diagnosis was correct with anatomically unilocular manifestation (77.04%). The median pain intensity was 4/10 on a visual scale. Ultrasound was the dominating diagnostic modality utilized (84.89%). Conventional compression therapy was the most common therapy applied (41.69%). Vascular anomalies are a rare disease and require many clinical specialties in the holistic management of children. The more familiar physicians and especially pediatric specialists become with them, the more patient care can improve. The contribution of radiology to provide comprehensive care for these patients includes imaging, minimally invasive therapies, and long-term follow-ups.