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Abstract：
OBJECTIVE: To compare the magnetic resonance imaging (MRI) and Doppler ultrasound (DUS) findings with the pathological findings of soft tissue vascular tumors (STVTs) according to the 2018 ISSVA (International Society for the Study of Vascular Anomalies) classification to differentiate vascular tumors from vascular malformations.
METHODS: This retrospective study included patients with STVTs who underwent contrast-enhanced MRI and pathological analysis at our hospital between 2010 and 2020. The presumptive diagnosis based on the on-site imaging and histological analysis was compared with imaging and histological analysis conducted off-site utilizing the ISSVA criteria.
RESULTS: This study included 31 patients with 31 vascular tumors located in the head and neck (n = 3), trunk (n = 2), and extremities (n = 26). The off-site pathological analysis confirmed benign vascular tumors in 54.8% of cases (non-involuting congenital hemangioma: 35.5%; epithelioid hemangioma: 13%; pyogenic granuloma: 3%; and spindle cell hemangioma: 3%). Based on the off-site histological analysis, 25.8% were reclassified as having a vascular malformation whereas three had other benign lesions. Only phleboliths were associated with a vascular malformation (p = 0.03). The concordance between off-site MRI and pathological findings was fair (k = 0.3902 (0.0531-0.7274)), whereas that between on-site and off-site pathological analyses was poor (k = -0.0949 (-0.4661 to 0.2763)).
CONCLUSIONS: Benign vascular tumors have non-specific imaging features on imaging with some overlap with atypical vascular malformations. Therefore, histological analysis is recommended. Imaging and pathological analyses should be performed in accordance with the ISSVA classification to minimize inter-observer discrepancies.
UNASSIGNED: Imaging features of benign vascular tumors on MRI are non-specific, leading to discrepancies with pathological findings and potential overlap with atypical vascular malformations. Imaging and histological analyses should be performed in accordance with ISSVA guidelines to improve patient management.
CONCLUSIONS: The imaging features of benign vascular tumors are non-specific. Histological analysis is recommended for soft tissue vascular tumors in adults. Analyses of soft tissue vascular tumors should be performed in accordance with ISSVA guidelines.
METHODS: This retrospective study included patients with STVTs who underwent contrast-enhanced MRI and pathological analysis at our hospital between 2010 and 2020. The presumptive diagnosis based on the on-site imaging and histological analysis was compared with imaging and histological analysis conducted off-site utilizing the ISSVA criteria.
RESULTS: This study included 31 patients with 31 vascular tumors located in the head and neck (n = 3), trunk (n = 2), and extremities (n = 26). The off-site pathological analysis confirmed benign vascular tumors in 54.8% of cases (non-involuting congenital hemangioma: 35.5%; epithelioid hemangioma: 13%; pyogenic granuloma: 3%; and spindle cell hemangioma: 3%). Based on the off-site histological analysis, 25.8% were reclassified as having a vascular malformation whereas three had other benign lesions. Only phleboliths were associated with a vascular malformation (p = 0.03). The concordance between off-site MRI and pathological findings was fair (k = 0.3902 (0.0531-0.7274)), whereas that between on-site and off-site pathological analyses was poor (k = -0.0949 (-0.4661 to 0.2763)).
CONCLUSIONS: Benign vascular tumors have non-specific imaging features on imaging with some overlap with atypical vascular malformations. Therefore, histological analysis is recommended. Imaging and pathological analyses should be performed in accordance with the ISSVA classification to minimize inter-observer discrepancies.
UNASSIGNED: Imaging features of benign vascular tumors on MRI are non-specific, leading to discrepancies with pathological findings and potential overlap with atypical vascular malformations. Imaging and histological analyses should be performed in accordance with ISSVA guidelines to improve patient management.
CONCLUSIONS: The imaging features of benign vascular tumors are non-specific. Histological analysis is recommended for soft tissue vascular tumors in adults. Analyses of soft tissue vascular tumors should be performed in accordance with ISSVA guidelines.
摘要：
目的：根据2018年ISSVA（国际血管异常研究学会）分类，比较磁共振成像（MRI）和多普勒超声（DUS）检查结果与软组织血管肿瘤（STVT）的病理结果，以区分血管肿瘤和血管畸形。
方法：这项回顾性研究包括2010年至2020年在我院接受对比增强MRI和病理分析的STVT患者。将基于现场成像和组织学分析的推定诊断与使用ISSVA标准进行的非现场成像和组织学分析进行比较。
结果：该研究包括31例患者，其中31例血管肿瘤位于头颈部（n=3），树干（n=2），和四肢（n=26）。非现场病理分析证实良性血管瘤占54.8%(非退化性先天性血管瘤:35.5%;上皮样血管瘤:13%;化脓性肉芽肿:3%;梭形细胞血管瘤:3%)。根据非现场组织学分析，25.8％的人被重新分类为患有血管畸形，而3人患有其他良性病变。只有静脉滴注与血管畸形有关（p=0.03）。非现场MRI和病理结果之间的一致性是一般的（k=0.3902（0.0531-0.7274）），而现场和非现场病理分析之间的差异较差（k=-0.0949（-0.4661至0.2763））。
结论：良性血管瘤在影像学上具有非特异性影像学特征，与非典型血管畸形有一些重叠。因此,建议进行组织学分析。应根据ISSVA分类进行影像学和病理学分析，以最大程度地减少观察者之间的差异。
■良性血管肿瘤的MRI成像特征是非特异性的，导致与病理结果的差异以及与非典型血管畸形的潜在重叠。应根据ISSVA指南进行影像学和组织学分析，以改善患者管理。
结论：良性血管肿瘤的影像学特征是非特异性的。建议对成人软组织血管肿瘤进行组织学分析。软组织血管肿瘤的分析应按照ISSVA指南进行。
方法：这项回顾性研究包括2010年至2020年在我院接受对比增强MRI和病理分析的STVT患者。将基于现场成像和组织学分析的推定诊断与使用ISSVA标准进行的非现场成像和组织学分析进行比较。
结果：该研究包括31例患者，其中31例血管肿瘤位于头颈部（n=3），树干（n=2），和四肢（n=26）。非现场病理分析证实良性血管瘤占54.8%(非退化性先天性血管瘤:35.5%;上皮样血管瘤:13%;化脓性肉芽肿:3%;梭形细胞血管瘤:3%)。根据非现场组织学分析，25.8％的人被重新分类为患有血管畸形，而3人患有其他良性病变。只有静脉滴注与血管畸形有关（p=0.03）。非现场MRI和病理结果之间的一致性是一般的（k=0.3902（0.0531-0.7274）），而现场和非现场病理分析之间的差异较差（k=-0.0949（-0.4661至0.2763））。
结论：良性血管瘤在影像学上具有非特异性影像学特征，与非典型血管畸形有一些重叠。因此,建议进行组织学分析。应根据ISSVA分类进行影像学和病理学分析，以最大程度地减少观察者之间的差异。
■良性血管肿瘤的MRI成像特征是非特异性的，导致与病理结果的差异以及与非典型血管畸形的潜在重叠。应根据ISSVA指南进行影像学和组织学分析，以改善患者管理。
结论：良性血管肿瘤的影像学特征是非特异性的。建议对成人软组织血管肿瘤进行组织学分析。软组织血管肿瘤的分析应按照ISSVA指南进行。
