2015 HSC Section 1 Book of Articles

A. Tekes et al. / Clinical Radiology 69 (2014) 443 e 457

Figure 5 (a) An 11-month-old female patient born with ill-de fi ned purple and fi rm, indurated lesion overlying the left knee region. The vascular anomaly was notable for being extremely painful, limiting movement of the left lower extremity. (b) This is a lateral view of an arteriogram of the left knee demonstrating enlarged feeders off the lower super fi cial femoral artery and popliteal fi lling the hypervascular mass. Multiple hypervascular branches arising from the geniculate artery supplying the blush of the KHE (white arrows). Note that the popliteal artery (black arrow) and anterior tibial artery (arrowhead) are also marked on the image for orientation purposes. (c) Axial contrast-enhanced T1-weighted image with fat saturation demonstrates in fi ltration of the skin, subcutaneous fat, muscle groups, and cortex of the bone by this enhancing in fi ltrative vascular anomaly. In fi ltrative and aggressive nature of this painful solid mass in a young child con fi rms the diagnosis of a KHE.

Figure 6 (a) A 4-year-old with blue discolouration of his right cheek and corner of right lip noted to be present since birth and stable. Note that the right cheek is fuller than the left. The lesions are soft and compressible. (b e c) Coronal images show in fi ltration of the right temporalis muscle and right masticator space by a T2 bright (b) and enhancing mass (c). Note the T2 dark round foci in b representing phleboliths (arrow). (d e f) DCE-MRA demonstrates no enhancement in the arterial phase (d). Enhancement starts in the venous phase (e) and progressively increases in the delayed venous phase (f), typical for VMs.

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