Intramuscular hemangioma is a diffusely growing hemangioma located in the transverse muscle, and is relatively rare, accounting for about 0.8% of cavernous hemangiomas. They are most commonly found in the extremities, followed by the face and trunk, and may be confined to one group or one muscle, sometimes invading tendons and nerves, causing pain or functional impairment. As early as the 1960s, Goidanich classified deep limb hemangiomas into four types: limited, extensive, multiple, and diffuse. Only limited hemangioma involving a muscle or a small area can be completely removed surgically, and recurrence is rare; for extensive, multiple and diffuse lesions, because the lesions involve a wide range and infiltrate important blood vessels and nerves or are accompanied by limb edema, distal ischemia and nutritional disorders, surgery can only be partially removed, but there are many complications of surgery and recurrence is easy, and the recurrence rate has been reported in the literature as 10-20 The recurrence rate has been reported to be 10-20%. Therefore, it is currently advocated that each IMH patient needs individualized treatment. 1.Surgical resection The current treatment principle of surgery is to remove all diseased tissues as much as possible while preserving the basic functions. The factors that affect the surgery include: tumor invasion to many fast muscles, tumor penetrating the envelope and infiltrating the surrounding tissues, complex local anatomy, bleeding in the operation field, improper surgical access, etc. Therefore, the preoperative accurate localization, characterization and treatment of IMH patients should be carried out. Therefore, accurate preoperative localization, characterization and detailed surgical planning are the keys to improve the efficacy and prevent recurrence. Existing scholars advocate that IMH should be embolized with gelatin sponge under DSA intervention before surgical resection, which also aims to reduce intraoperative bleeding and make the surgical field clearer and resection more complete. The aim is also to reduce intraoperative bleeding, make the surgical field clearer, and make the resection more complete. 2.Laser treatment is suitable for patients with diffuse hemangioma that cannot be surgically removed or not completely removed. Its treatment mechanism: Nd:YAG laser has a wavelength of 1.06μm, which is an invisible near-infrared laser, and can be selectively absorbed by a large amount of reduced hemoglobin in the vascular malformation tissue, while other tissues absorb very little, so the laser energy is mainly distributed inside the lesion. The light energy acts on the endothelial layer of blood vessels in the form of thermal energy, producing selective coagulation and destruction, causing the coagulation and destruction of vascular tissues and their elimination. According to the scope and distribution of the tumor, Xu Songlin et al. inserted optical fiber into the tumor through the normal skin and irradiated it in multiple levels and directions to make it coagulate and retract. The Nd:YAG laser has strong photocoagulation and hemostatic effect, so there is little chance of bleeding during the treatment of hemangioma. However, it should be noted that the dose at the treatment should not be too high, and the focal beam should not be used to irradiate the tumor, otherwise it may cause rupture and bleeding of the tumor wall when treating spongy and mixed hemangioma. If this happens, the bleeding can be stopped by compression, or by pressing the bleeding point, photocoagulating the periphery of the bleeding point or even the whole tumor, or by local use of hemostatic powder or gelatin sponge and then bandaging. Such bleeding cannot be stopped with vascular clamp, nor can it be treated with suture, otherwise it will enlarge the breakage of the tumor wall and aggravate the bleeding. 3.Electrochemical therapy Electrochemical therapy is the application of one-way direct current to make the vascular-interstitial closed circuit system activated by non-physiological reinforcement, forming a certain intensity of bioelectric field in local tissues, causing electrochemical and electrophysiological changes in local tissues through electrolysis, electrophoresis and electroosmosis, leading to changes in cellular enzyme activity and protein denaturation, and producing new ecological chlorine, oxygen and hydrogen with cell-killing effects. The pH value of the anodic area decreases to 2-2.5, which is strongly acidic, dehydrating the tissue and causing extensive formation of microthrombi; the pH value of the cathodic area is 11-13, which is strongly alkaline, causing tissue edema and compressing capillaries, etc. The specific method is: preoperatively, according to the imaging diagnosis, the lesion site is clearly defined, and the special electrode needle (platinum electrode needle, diameter 0,7mm, length 18cm) is directly introduced into the tumor with a trocar needle, the depth depends on the size of the tumor, and the needle is evenly placed at a distance of 1cm to 1.5cm (B ultrasound monitoring can be applied intraoperatively), and connected with the electrochemical therapy instrument to give 80-100MA electro-pop electrochemical therapy. 100MA electro-pop electrochemical treatment. For multiple tumor foci, depending on the size and distance of the foci, the treatment can be performed in parallel with the same conductor or in parallel with multiple conductors. The amount of electricity is calculated using 100 coulombs for 1 cm2 tumor. During the treatment, more gas can be seen to escape between the electrode needles of the tumor, and the overflowing blood becomes black and hard after the treatment. 4.Copper needle treatment Suitable for hemangioma with wider range. For the more extensive hemangioma, a number of puncture locations, directions and depths are determined on the body surface using color Doppler ultrasound (CD). The procedure is determined under local anesthesia, continuous epidural or general anesthesia depending on the lesion site. The skin at the calibration point is punctured with a thick needle and a copper needle of 1 to 2 mm diameter (sterilized and polished to remove the surface oxidation layer) is placed in the determined direction to the determined depth. Then energization or retention is performed. The ultrasound probe, disinfected with gas fumigation, is used to guide the copper needle directly to the vascular sinus and lumen one by one under the monitoring of the visualization, and then energized or left in place. Copper needle treatment of hemangioma has the advantages of simplicity and economy, but also has the shortcomings of postoperative local sepsis and scar formation. 5.Embolytic therapy Interventional embolization treatment of hemangioma has the advantages of accurate treatment site and precise efficacy. Especially for diffuse hemangioma in the extremities or maxillofacial area, the blood supply is rich, and the imaging can show that the blood sinuses in the tumor are obviously tortuous, dilated in a cystic shape and folded. In some cases, a large blurred shadow can be seen. Selective vascular embolization can block the blood supply of the tumor and reduce the scope of the lesion, and surgical resection, electrochemical treatment and laser treatment can be carried out on this basis to achieve good treatment results. The therapeutic effect is closely related to the size and location of the tumor, blood supply and drainage, as well as the level of super-selective cannulation and the choice of embolization materials. The size and location of the tumor, blood supply and drainage, and the level of superselective cannulation determine the choice of embolization materials. If the tumor is large or extensive, embolization of both the tumor nest and the blood supply vessel should be done to avoid collateral circulation after embolization of the blood supply vessel; if the tumor is adjacent to an important organ or structure, embolization of the central or blood supply vessel should be performed; the thickness of the blood supply vessel determines the diameter of embolization material (intraoperative measurement of vessel thickness is required), and the extent of blood supply and collateral circulation determines the amount of embolization material; in cases with arteriovenous fistula, embolization of the fistula should be done to avoid heterotaxy. The embolization of the arteriovenous fistula should be done in order to avoid ectopic embolization. 6.Injection therapy At present, injection therapy is mainly based on sclerosing agents, such as 5% sodium cod liver oil, anhydrous ethanol, alum, pinyamycin, hypertonic glucose, etc., alone or with surgical treatment. Its efficacy is variable depending on the size of the lesion site, blood flow traffic condition, injection dose, concentration, drug retention time in the tumor, injection method and other factors. For some extensive lesions, which are closely related to larger nerves and blood vessels and cannot be completely removed by surgery, sclerotherapy can be used in combination with sclerotherapy. Intramuscular hemangiomas require different treatment protocols because of the different extent of the lesion and the differences in the adjacent relationship of the surrounding tissues. The combination of various methods must be the trend of treatment for this disease and will lead to better results.