CT and MRI Manifestations and Misdiagnosis Analysis of Fibro-Adipose Vascular Anomaly in Children
10.3969/j.issn.1005-5185.2025.06.018
- VernacularTitle:儿童法瓦病CT、MRI表现及误诊分析
- Author:
Tingting LI
1
;
Xiujun YANG
1
;
Huanhuan ZHANG
1
Author Information
1. 上海交通大学医学院附属儿童医院影像科,上海 200062
- Publication Type:Journal Article
- Keywords:
Fibro-adipose vascular anomaly;
Tomography,X-ray computed;
Magnetic resonance imaging;
Pathology,surgical;
Diagnostic errors;
Child
- From:
Chinese Journal of Medical Imaging
2025;33(6):665-669
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To explore the clinical features and CT/MRI manifestations of fibro-adipose vascular anomaly(FAVA)in children,and to analyze the misdiagnosis reason,in order to improve the diagnostic accuracy.Materials and Methods A retrospective analysis was conducted on 15 pediatric patients with pathologically confirmed FAVA in Shanghai Children's Hospital,School of Medicine,Shanghai Jiao Tong University from January 2014 to April 2024.Among them,11 underwent CT,10 underwent MRI,and 6 underwent both CT and MRI.Their CT and MRI imaging features were analyzed.Results All 15 cases presented single lesion,including eight boys and seven girls,aged from 1 year 7 months to 14 years and the median age was 8 years(6 years and 4 months to 10 years).Clinical manifestations were slow-growing masses in the soft tissues of the limbs or trunk,of which 11 cases were accompanied by pain,two cases by claudication or activity limitation and two cases by skin bruising.CT showed that the lesions were located in intramuscular,intermuscular or subcutaneous tissues;eight cases were iso-hypo-dense,three cases slightly hyper-dense or mixed-dense,ten cases showed fat density and two cases showed venous stone.MRI showed that the lesions were clearer,with fat signals visible in the internal or peripheral areas.The lesions were well defined,with fat signal inside or around the periphery,located in muscle and growing in a shuttle shape along the long axis of the muscle.The fascial tail sign was seen in six cases.All 15 cases showed significant inhomogeneous enhancement,and increased vascularization was seen around the lesions in four cases.Among the 15 pediatric patients,seven were misdiagnosed as vascular malformations,five as hemangiomas,one as angiolipoma,one as inflammatory myofibroblastoma and one was not qualitatively diagnosed.Conclusion The CT and MRI manifestations of FAVA in children have certain characteristics,but they are still prone to misdiagnosis.When intramuscular lesions are found to grow spindle-shaped along the long-axis,containing fat density/signal and blood vessels or vascular clusters,accompanied by fascial tail sign,combined with clinical manifestations such as pain,the possibility of this disease should be considered.
