Hemangioma of skin and subcutaneous tissue [D18.01], Reason for Study: ^Reason: Evaluate for PHACE syndrome and possibly airway hemangioma in infant with segmental hemangioma of R face History: Hemangioma involving R lower lip, cheek, pre-auricular region and tragus Brain MRIThere is no evidence of acute ischemic or hemorrhagic lesion.There is no evidence of abnormal enhancement.Myelination degree is normal for the patient age. In particular, there is no evidence of posterior fossa brain abnormality.The ventricles, sulci and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. The paranasal sinuses and mastoid air cells are clear.Brain MRA3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.Neck MRA3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries. Neck MRIThere are multifocal well-circumscribed multi compartmental lesion involving right parotid and right submandibular space as well as bilateral posterior triangles. The longest diameter of the lesion measured at the deep lobe of the right parotid gland which extends toward posterior aspect of the right medial pterygoid muscle is about 35mm and craniocaudal direction measurement is about 32mm.The lesions show T2 high signal intensity, T1 low or iso to adjacent muscle signal intensity with relatively homogeneous enhancement. Especially on T2 weighted images, some of compartments show fluid fluid level indicating internal blood products. Constellation of above findings indicate benign lesions such as such as muti-focal hemangiomas. Lymphangiomas and venous vascular malformations are differential diagnosis but less likely based on MR signal characteristics. Airway does not appear to be compromised and widely patent.
1. No evidence of intracranial abnormality, especially posterior fossa appears to be normal.2. Normal brain and neck MRA3. Multifocal hemangiomas involving right parotid space, right submandibular space as well as bilateral posterior triangles. Lymphangiomas and venous vascular malformations are differential diagnosis but less likely based on MR characteristics.4. No MR evidence of airway compromise due to the lesion. 