Colour Doppler ultrasound imaging findings in paediatric periocular and orbital haemangiomas

Purpose: To evaluate the combined grey-scale ultrasonography (US) and colour Doppler imaging (CDI) as the first and primary imaging modalities in diagnosing paediatric orbital haemangiomas. Methods: The charts of 20 consecutive children with a periorbital mass echographically diagnosed as a haemangioma between January 2004 and June 2009 in the Tel-Aviv Sourasky Medical Center were reviewed. Data on demographic details, clinical findings, US and CDI characteristics, treatment and outcome were retrieved. Results: Twelve (60%) haemangiomas were located on the upper eyelid, five in the lower eyelid (25%) and three in the medial cantus (15%). The tumour resolved completely in 10 children (50%) and in 10 children (50%) partial resolution was documented. Seven (35%) patients underwent treatment (intralesional or oral steroids or propranolol). Grey-scale US depicted a solid-tissue mass with low internal echogenicity. Mean haemangioma volume was 1.33 cm³. Colour Doppler imaging demonstrated intralesional flow with a mean peak systolic velocity of 15.2 cm per second and a mean resistance index of 0.51. All US and CDI examinations were carried out on alert children and no sedation or general anaesthesia was needed. During mean follow-up time of 23 months, no child required any additional imaging or diagnostic procedures to confirm the diagnosis. Conclusion: Combined US and CDI are suggested as the first imaging modalities in cases with a suspected diagnosis of periocular and orbital capillary haemangioma.