Imaging of peripheral vascular malformations - current concepts and future perspectives.

IF 2.4 Q1 PEDIATRICS Molecular and cellular pediatrics Pub Date : 2021-12-07 DOI:10.1186/s40348-021-00132-w
Vanessa F Schmidt, Max Masthoff, Michael Czihal, Beatrix Cucuruz, Beate Häberle, Richard Brill, Walter A Wohlgemuth, Moritz Wildgruber
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引用次数: 12

Abstract

Vascular Malformations belong to the spectrum of orphan diseases and can involve all segments of the vascular tree: arteries, capillaries, and veins, and similarly the lymphatic vasculature. The classification according to the International Society for the Study of Vascular Anomalies (ISSVA) is of major importance to guide proper treatment. Imaging plays a crucial role to classify vascular malformations according to their dominant vessel type, anatomical extension, and flow pattern. Several imaging concepts including color-coded Duplex ultrasound/contrast-enhanced ultrasound (CDUS/CEUS), 4D computed tomography angiography (CTA), magnetic resonance imaging (MRI) including dynamic contrast-enhanced MR-angiography (DCE-MRA), and conventional arterial and venous angiography are established in the current clinical routine. Besides the very heterogenous phenotypes of vascular malformations, molecular and genetic profiling has recently offered an advanced understanding of the pathogenesis and progression of these lesions. As distinct molecular subtypes may be suitable for targeted therapies, capturing certain patterns by means of molecular imaging could enhance non-invasive diagnostics of vascular malformations. This review provides an overview of subtype-specific imaging and established imaging modalities, as well as future perspectives of novel functional and molecular imaging approaches. We highlight recent pioneering imaging studies including thermography, positron emission tomography (PET), and multispectral optoacoustic tomography (MSOT), which have successfully targeted specific biomarkers of vascular malformations.

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外周血管畸形的影像学-目前的概念和未来的展望。
血管畸形属于孤儿病谱系,可涉及血管树的所有部分:动脉、毛细血管和静脉,同样也包括淋巴血管。根据国际血管异常研究学会(ISSVA)的分类对指导正确的治疗具有重要意义。根据主要的血管类型、解剖延伸和血流模式对血管畸形进行分类,影像学起着至关重要的作用。彩色编码超声/超声造影(CDUS/CEUS)、4D计算机断层血管造影(CTA)、磁共振成像(MRI)包括动态对比增强磁共振血管造影(DCE-MRA)、常规动脉、静脉血管造影等影像学概念在目前的临床常规中得到确立。除了血管畸形的异质性表型外,分子和遗传图谱最近提供了对这些病变的发病机制和进展的深入了解。由于不同的分子亚型可能适合靶向治疗,通过分子成像捕获某些模式可以增强血管畸形的非侵入性诊断。本文综述了亚型特异性成像和已建立的成像模式,以及新型功能和分子成像方法的未来前景。我们重点介绍了最近的成像研究,包括热成像、正电子发射断层扫描(PET)和多光谱光声断层扫描(MSOT),这些研究已经成功地针对血管畸形的特定生物标志物。
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