Various imaging tools are available for the diagnosis of vascular malformations (1–5). Techniques must be adapted to the clinical findings and to the aim of imaging, which may be diagnosis, pre-therapeutic assessment, or follow-up with or without treatment.

Conventional X-Rays

These are usually of little interest and are normal in most situations. Venous malformations may be diagnosed if phleboliths are seen on plain radiographs. Bone distortion is only seen in large malformations with an important soft tissue mass effect. Some diffuse venous malformations in the limbs match up with fragile, thinner, curved bones, and sometimes lytic lesions, and a risk of pathologic fracture. Occasionally, an arteriovenous malformation involves a bone and either the intraosseous nidus, or large draining venous channels, after the nidus, create lytic bony lesions.

Ultrasonography in Combination with Doppler

This scan is frequently used as the primary diagnostic tool (4). It often permits distinction between tumors and malformations. It also allows a vascular malformation to be identified and pinpoints the type of lesion. It shows whether the lesion is cystic or tissular, demonstrates the presence or absence of flow, and thus differentiates between fast-flow and slow-flow malformations. Angioarchitecture and vessel density may be analyzed but reliability is often poor. Peak flow velocities and arterial output may also be measured in AVMs.