Imaging description

Mulliken and Glowacki’s seminal work resulted in a widely accepted biologic classification of congenital vascular anomalies into vascular tumors (hemangiomas) and vascular malformations, based on their endothelial characteristics [1]. Hemangioma is a vascular tumor characterized by rapid endothelial proliferation shortly after birth. The lesion is typically absent at birth, demonstrates growth in early infancy, followed by a spontaneous resolution in childhood.

On the other hand, vascular malformations are structural anomalies that have a normal growth rate and endothelial turnover. These are congenital, have an equal gender incidence, and almost never involute spontaneously. These lesions can be divided into low-flow vascular malformations (LFVMs) (capillary, venous, lymphatic, and mixed) and high-flow vascular malformations (arteriovenous malformations and fistulas).

The capillary malformations (e.g., port-wine stains) are well-demarcated lesions, typically pink in infancy. Imaging is typically done to exclude associated deeper lesions and associated CNS or ocular abnormalities, rather than to assess the capillary malformation itself. Venous and lymphatic malformations of the head and neck may present with a mass or facial deformity and may coexist.