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Figure 5
(a) An 11-month-old female patient born with ill-de
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ned purple and
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rm, indurated lesion overlying the left knee region. The vascular
anomaly was notable for being extremely painful, limiting movement of the left lower extremity. (b) This is a lateral view of an arteriogram of
the left knee demonstrating enlarged feeders off the lower super
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cial femoral artery and popliteal
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lling the hypervascular mass. Multiple
hypervascular branches arising from the geniculate artery supplying the blush of the KHE (white arrows). Note that the popliteal artery (black
arrow) and anterior tibial artery (arrowhead) are also marked on the image for orientation purposes. (c) Axial contrast-enhanced T1-weighted
image with fat saturation demonstrates in
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ltration of the skin, subcutaneous fat, muscle groups, and cortex of the bone by this enhancing
in
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ltrative vascular anomaly. In
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ltrative and aggressive nature of this painful solid mass in a young child con
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rms the diagnosis of a KHE.
Figure 6
(a) A 4-year-old with blue discolouration of his right cheek and corner of right lip noted to be present since birth and stable. Note that
the right cheek is fuller than the left. The lesions are soft and compressible. (b
e
c) Coronal images show in
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ltration of the right temporalis muscle
and right masticator space by a T2 bright (b) and enhancing mass (c). Note the T2 dark round foci in b representing phleboliths (arrow). (d
e
f)
DCE-MRA demonstrates no enhancement in the arterial phase (d). Enhancement starts in the venous phase (e) and progressively increases in the
delayed venous phase (f), typical for VMs.
A. Tekes et al. / Clinical Radiology 69 (2014) 443
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