Banishing Birthmarks With MRIs
Magnetic Resonance Imaging Can Guide Treatment, Say Experts
By Miranda Hitti

Treating some unsightly birthmarks is easier with magnetic resonance imaging (MRI), say researchers from Case Western Reserve University.

Birthmarks can be more than a common cosmetic annoyance. Some of these malformations cause a bluish skin discoloration, local swelling, and pain.

While some of these vascular birthmarks vanish with age and many remain stable, others worsen over time, causing disfigurement and bleeding. Most birthmarks are just colored skin spots, which may be raised above the surface of surrounding skin. In rare cases, they may indicate more serious health problems.

Birthmarks don't necessarily require treatment. Unless there's a medical, emotional, or cosmetic reason for removal, many birthmarks could stay harmlessly in place, if that's what the patient prefers.

Jonathan Lewin, MD, and colleagues recently performed imaging of these vascular birthmarks with MRIs on 15 adults who wanted them removed. He chairs the radiology department at Johns Hopkins University in Baltimore, Md.

Diagnosing these abnormal veins which make up the birthmarks is easy on exam, yet an MRI image is necessary to confirm the diagnosis. Imaging assesses the extent of these lesions, which can involve not only the skin but can involve muscle and deeper tissues layers.

Experienced and trained radiologists performed a procedure called sclerotherapy that constricts these abnormal veins that made up the birthmarks. The procedure involves injecting a scarring solution directly into the lesion.

In the study a total of 76 birthmarks were successfully treated. MRI was used to guide and monitor the operation, as well as in verifying results and conducting follow-up examinations.

Without MRI, it can be tough to catch all the veins in such birthmarks, as well as little extensions that often run from the veins into surrounding tissue.

MRI makes those veins as 'bright as light bulbs' says Lewin in a news release.

Lewin and colleagues call MRI-guided sclerotherapy for treatment of these vascular birthmarks safe and effective in their report, which appears in The November issue of The journal Radiology.

The researchers also note that using MRI imaging of the birthmark during the procedure significantly shortened the procedure time, easing patients' anxieties.

The operations length was "the most physically stressful and disturbing part of the entire treatment," they write.

In addition, patients stayed awake during the procedure and could "directly communicate sensations of pain or discomfort to the performing radiologist, who in turn was able to respond immediately by changing the needle location or the amount of sclerosing agent applied."

In the past, parents and doctors were often reluctant to treat birthmarks in babies and children, says New York dermatologist Joshua Fox, MD, in a news release.

Fox, who was not involved in the MRI birthmark study, says technological advances (such as laser treatments) have made it possible to treat birthmarks in children at younger ages.

Fox is the founder of Advanced Dermatology P.C. and The Center for Laser and Cosmetic Surgery .