Doppler Ultrasound Evaluation of Infantile Hemangiomas Treated with Oral Propranolol Solution: 5 Years of Experience in a Single Institution

Background: Infantile hemangioma (IH) is a common benign vascular tumor that occurs during infancy.Oral propranolol is used as a first-line treatment.However, standardized guidelines for evaluating treatment efficacy, particularly the appropriate timing and parameters for Doppler ultrasound (US), have not been established.This study reports on the evaluation of therapeutic efficacy of oral propranolol solution in IH patients using Doppler US, and aims to propose the appropriate timing and parameters for using Doppler US based on this experience.Methods: A retrospective analysis was conducted on 120 patients with IH who were treated with oral propranolol solution and maintained for over 6 months from May 2017 to April 2023.Doppler US evaluation of IH was performed at diagnosis, 1-2 and 6-12 months after treatment initiation, and 6 months post-therapy cessation.A complete response (CR) was identified as a reduction in vascularity along with a decrease in longest diameter (LD) or thickness of 50% or more.Recurrence was evaluated based on increased vascularity or size 6 months after treatment discontinuation.Results: Of 120 patients with IH, 82 females and 38 males were analyzed.IH was first detected at a median age of 12 days (range, 1-240 days), and treatment began at 76 days (range, 27-570 days), continuing for an average of 10.4 months (range, 5-24 months).Initial Doppler US measurements showed an LD of 2.651.52cm and a thickness of 0.790.55cm, with prominent vascularity.After 1-2 months of treatment, LD and thickness decreased by 12.9% and 25.9%, respectively.By 6-12 months, reductions reached 37.2% and 53.6%.CR occurred in 77 patients (64.2%) after 6-12 months of treatment.Eleven patients (9.2%) experienced a recurrence.Conclusion: Doppler US is a valuable modality for evaluating the characteristics, treatment response, and recurrence of IH treated with oral propranolol.