Imaging of head and neck venous malformations

Abstract

Venous malformations (VMs) are non proliferative lesions that consist of dysplastic venous channels. The aim of imaging is to characterise the lesion and define its anatomic extent. We will describe the plain film, ultrasound (US) (including colour and duplex Doppler), computed tomography (CT), magnetic resonance imaging (MRI), conventional angiographic and direct phlebographic appearances of venous malformations. They will be illustrated at a number of head and neck locations, including orbit, oral cavity, superficial and deep facial space, supraglottic and intramuscular. An understanding of the classification of such vascular anomalies is required to define the correct therapeutic procedure to employ. Image-guided sclerotherapy alone or in combination with surgery is now the first line treatment option in many cases of head and neck venous malformations, so the radiologist is now an integral part of the multidisciplinary management team.

Intraosseous venous malformation in the anterior mandible: Report of a rare case

“…Prominent dysplastic veins may also be identifi ed. [9] In the present case, the radiographic features were suggestive of a radiolucent lesion with wide loculations and resorption of roots of associated teeth. Contrast CT image showed a non expansile osteolytic lesion with focal erosion of anterior cortex of the alveolar process of the mandible.…”

“…Besides these two techniques, a wide variety of methods like irradiation, electrocoagulation, cryotherapy, intravascular magnesium or copper needles, and compression have also been described in literature. [9] In the present case, segmental resection of the mandible was performed followed by reconstruction with free fi bula graft.…”

An unusual presentation of intramasseteric vascular malformation

“…[8] US is commonly used to the delineate the margins of the lesion when it is located more superficially. [16] Experienced radiologists can differentiate malformations (specifically venous, arteriovenous and lymphatic anomalies) from hemangiomas based on US. Infantile hemangiomas on gray scale US are well defined, solid and homogenous.…”

“…[7] Sclerotherapy is aimed at obliterating the lumen by causing fibrosis of patent vessels. [16] Sodium tetradecyl sulfate, ethanol, polidocanol, hypertonic saline, and sodium morrhuate are the commonly used sclerosing agents. [7] US can be used to prevent intra-arterial injection and to assess the extent of sclerosis.…”

“…[12] Both the lesions are easily compressible. [2,3,7,[14][15][16] Purely venous and purely lymphatic malformations are rare, and they generally occur in combination. Venous malformation has the tendency to expand and contract with the change of patient's posture as it is a dependent lesion.…”