What is an ultrasound scan?

This is most often the first examination performed. It is a non-invasive examination using ultrasound to visualize the images; the ultrasound probe box is placed on the area to be explored after applying a gel to the skin.
This initial examination helps to visualize the lesion, to distinguish a tissue or malformative lesion, and can sometimes be sufficient on its own to make the diagnosis.

The color Doppler technique is performed in addition, and consists in visualizing the blood vessels, arteries and veins. Blood flow in and around the malformation is analyzed, enabling better classification of the type of malformation or tumoral vascularization.
Doppler ultrasound is also part of the follow-up examinations for treated or untreated arteriovenous malformations.

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What is MRI (Magnetic Resonance Imaging)?

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An MRI is an imaging test that uses the properties of a magnetic field to produce images. It is a non-irradiating examination, but requires the wearing of hearing protection as it is relatively noisy. The main disadvantage is the need to pass through a ring or longitudinal tube, which can cause anxiety in some people. However, this tube remains open at the head and feet.
The examination also takes longer (15-20 min), due to the acquisition of the various sequences and images. An injection of contrast medium is sometimes required.

This is the 2nd most frequently performed examination, as it is very useful and informative. It completes the diagnostic work-up of the malformation, assessing the consistency of the lesion (fatty, tissue, vascular, etc.) and its extension into adjacent structures (fatty tissue, muscle, bone). MRI is often requested prior to any therapeutic procedure, and may be repeated during follow-up to assess evolution and regression.

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What is a Scanner?

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The CT scanner is an imaging examination during which the patient lies on a table that fits into a small ring or tube, enabling images to be acquired.
This fast examination uses X-rays and sometimes requires the injection of a contrast medium to better differentiate certain structures as well as blood vessels. For this, a perfusion tube is inserted.

- In the case of venous malformations, it can detect phleboliths, sequelae of thrombosis phenomena within venous pockets.
- It can be used to assess the extent of arteriovenous malformations, particularly bone damage, and after injection of the contrast medium, to reconstruct the blood vessels supplying and draining the malformation
It should be avoided whenever possible in pregnant women.

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What is an arteriogram?

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Arteriography is an imaging test also using X-rays, but this time requiring an injection of contrast medium directly into the vessels. To do this, a catheter is passed through the arteries to the malformation and images are taken for a few seconds.
This imaging technique is more invasive and requires aseptic measures as in an operating theatre. A leg or wrist artery is punctured under local anaesthetic. This examination requires hospitalization, either on an outpatient or inpatient basis, with an overnight stay after the procedure.

In the vast majority of cases, this imaging test is used to assess arteriovenous malformations or similar types of malformations, but is of little use for other malformations. It can also be used to plan surgery or embolization.
It should be avoided whenever possible in pregnant women.

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What is a Biopsy?

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When the diagnosis is uncertain, despite the various imaging modalities performed, you may be offered a biopsy. This involves taking either a superficial sample from the skin and mucous membranes, or a deep sample for anatomopathological analysis under a microscope.

After disinfection and local anaesthesia, a sample is taken with a needle (sometimes with the help of ultrasound or CT scan) and sent to the hospital laboratory for analysis.

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