International Society for the Study of Vascular Anomalies (ISSVA) Classification of Soft Tissue Vascular Anomalies: Survey-based Assessment of Musculoskeletal Radiologists′ Use in Clinical Practice

Publication date: Available online 16 October 2017
Source:Current Problems in Diagnostic Radiology
Author(s): Shivani Ahlawat, Laura M. Fayad, Daniel J. Durand, Kate Puttgen, Aylin Tekes
AimThere is controversy regarding the diagnosis and classification of vascular anomalies (VA). Since torso and extremities are the second most common body part for presentation of VAs, musculoskeletal (MSK) radiologists play a central role in VA classification. The purpose of this study was to evaluate the awareness and clinical use of the International Society for the Study of Vascular Anomalies (ISSVA) classification by MSK radiologists. Materials and Methods: A Web-based survey was designed and electronically sent to Society of Skeletal Radiology (SSR) members, with three questions on demographics and 7 questions on ISSVA classification use and knowledge. The Z-test for binomial proportions is used to assess for statistical significance between sub-groups. Results: The response rate was 12% (130/1091), comprised of 64% (83/130) academic and 36% (47/130) non-academic MSK radiologists. VAs accounted for only a small (0–5%) proportion of clinical practice in the majority 92% (119/130). Only 17% (22/130) of MSK radiologists used the ISSVA classification in practice. Of all respondents, 74% (94/127) considered hemangioma a type of vascular malformation (VM). There was no significant difference in the response characteristics between academic and non-academic radiologists. A greater proportion of MSK radiologists with >5years′ experience provided responses that were discordant with the ISSVA classification compared with less experienced radiologists (0–5years) in diagnosing hemangiomas in adult patients (p=0.02), and using the presence of phleboliths to diagnose hemangiomas (p = 0.004).ConclusionOur survey results indicate a lack of familiarity with the ISSVA classification by the MSK radiology community.



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