Color Doppler Ultrasound Follow-Up of Infantile Hemangiomas and Peripheral Vascularity in Patients Treated with Propranolol

Abstract

BackgroundInfantile hemangiomas (IHs) are the most common vascular tumors in childhood. Diagnosis of IHs is usually clinical, however, to determine the actual dimensions of the lesion or the anatomic changes that occur during its evolution and treatment, a color Doppler ultrasound (CDU) examination can be performed. To date, there are few publications that assess the sonographic response to propranolol in IHs, and to our knowledge, none that consider simultaneous evaluation of both intralesional and normal peripheral blood vessels in these cases.

ObjectiveEvaluation of the anatomic effect of propranolol in IHs and peripheral blood vessels using CDU.

MethodsA cohort study was performed in 10 pediatric patients with a diagnosis of IH in whom systemic therapy with propranolol was indicated. The patients underwent a baseline and 3-month follow-up CDUs of the tumor and the main peripheral vessels of the right upper extremity.

ResultsThe group was composed of 7 (70%) girls and 3 (30%) boys. The average CDU decrease in size of the longitudinal axis was 11%; of the transverse axis, 24%; tumor thickness, 30%; and intralesional vessel thickness, 46%. Hemangioma volume measured by CDU decreased an average of 51%. The thickness of the peripheral vessels did not change significantly between the baseline and 3-month follow-up CDUs.

ConclusionCDU permits noninvasive quantification of the changes in IHs and peripheral vessels in patients receiving propranolol therapy. In our cohort of cases there was a significant reduction in tumor volume; however, peripheral vascularity was not significantly affected.