The Application Value Of Three-dimensional Color Power Angiography In Diagnosis And Treatment Of Infantile Hemangioma

Objective:To assess the use of three-dimensional power Doppler ultrasonography(3D-CPA)for pretreatment evaluation of refractory infantile hemangioma(IH),for guidance of clinically effective percutaneous local drug perfusion treatment,for follow-up assessment after treatment and for treatment efficacy determination.Methods:According to clinical characteristics and ultrasound findings,47 patients(48 lesions)with refractory IH suitable for bleomycin local perfusion therapy who met the inclusion criteria were screened.Two-dimensional ultrasound data,including the three-dimensional volume(V),vascularization index(VI),flow index(FI),and vascularization-flow index(VFI)of the lesions,were collected for each patient before treatment and during the first and second months after treatment,and the medical information of each treatment was recorded.During later data processing,the percentage increase and decrease in the three-dimensional V parameters before and after treatment and the ratio of the bleomycin injection V to the three-dimensional V of the hemangioma before treatment were calculated,and statistical analysis was performed.Results:1.After percutaneous local drug perfusion therapy for refractory IH,37 patients showed significant improvement within 1 month(including 8 patients with 7 points and 29 patients with 6 points;77.08%),6 patients had basic control(including 2 patients with 4 points,2 patients with 3 points and 2 patients with 2 points;12.5%),and treatment was ineffective in 5 patients(including 1 patient with 1 point and 4 patients with continued growth after treatment;10.42%).2.One month after the first treatment review,the increasing and decreasing trends in VI in patients with three-dimensional V reduction occurred,but the third reduction before treatment showed a uniform decreasing trend.The parameters showed a uniform increasing trend;VI was always consistent with VFI during the follow-up period.3.The safe and effective dose of bleomycin for refractory IH was 0.34±0.03 ml/cm~3,and the single maximum dose was?2.0 ml.The percent reduction in three-dimensional V(V%)was 70.27±6.27%.Conclusion:3D-CPA technology can provide rich internal lesion information and accurate lesion V measurement before percutaneous local drug perfusion in children with refractory IHs.The changes in three-dimensional parameters can also accurately demonstrate the evolution of the blood supply in the lesion,which may be a new way to study the mechanism of hemangioma regression in infants and young children.More importantly,3D-CPA technology can also be used to quantitatively assess changes in lesion V and guide the effective and rational use of interventional drugs and has clinical value for quantitative analysis of percutaneous local drug perfusion therapy for refractory IH.