Classification and ultrasound findings of vascular anomalies in pediatric age: the essential

Conclusions
Typically, vascular anomalies may appear as isolated lesions, 
but both the clinician and the radiologist must know that 
they are often associated with regional or diffuse diseases 
Fig. 17
Macrocystic lymphatic malformation in 1-month-old boy. 
Doppler sonogram shows flow that is confined to the septa. Spectral 
analysis shows arterial flow with high resistance
Fig. 18
Arteriovenous malformation in 3-month-old boy. Hypoechoic 
subcutaneous lesion (*) with thin hyperechoic rim (arrows)
1
Classification proposed in 1990. The scheme was never published 
directly by the author but subsequently presented by Mulliken et al. 
[
56
–
58
].

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22
Journal of Ultrasound (2019) 22:13–25
1 3
(Table 
1
). The treatment of these diseases goes beyond the 
scope of this brief review. For their study, we refer to more 
specialized texts.
As repeated several times, the overlap of the ultrasound 
and color Doppler findings, both among the vascular anoma-
lies and neoplastic lesions of different nature, often makes a 
safe differential diagnosis difficult if not impossible. How-
ever, we must remember that ultrasound is often not asked 
for a diagnosis of nature but an examination that is scrupu-
lous and that gives information as completely and precisely 
as possible. For these reasons, we consider it useful to pro-
pose a report scheme to standardize the examination, so as to 
reduce as far as possible the dependency on the operator of 
the ultrasound and to improve the communication between 
the radiologist and the clinician.
The scheme is shown in Table 
2
.
Fig. 19
Arteriovenous malformation in 4-year-old boy. Color Doppler 
shows arterial flow with low resistance and high velocities