eMedicine Specialties > Radiology > Vascular/Interventional
Vascular Anomalies: Multimedia
Updated: Mar 23, 2007
Multimedia
 | Media file 1: Vascular anomalies. Infantile hemangioma. Coronal contrast-enhanced T1-weighted image shows the classic MRI appearance of infantile hemangioma. A well-rounded homogeneously enhancing cervical mass is associated with high-flow vessels (signal voids) in and around the mass. Most of these lesions require no additional testing for diagnosis. |
 | Media file 2: Vascular anomalies. Infantile hemangioma. Coronal contrast-enhanced T1-weighted MRI of an infant's head shows a large facial mass lesion that involves the skin and that extends into the left orbit. Small tubular hypointensities are seen; these are consistent with flow voids and represent high-flow vessels in the lesion. On the basis of the imaging features and the patient's age, these findings are consistent with infantile hemangioma. |
 | Media file 3: Vascular anomalies. Kaposiform hemangioendothelioma (KHE). Axial T2-weighted MRI obtained through the face shows an extensive soft-tissue abnormality in the right facial area that involves the adjacent osseous structures and extends into the oropharyngeal structures; it results in significant airway narrowing. |
 | Media file 4: Vascular anomalies. Arteriovenous malformation (AVM). Photograph of the right hand of a patient shows soft-tissue swelling but no skin discoloration (see Image 5). |
 | Media file 5: Vascular anomalies. Arteriovenous malformation (AVM). A young boy (patient in Image 4) presented with soft-tissue swelling and pain in the right hand. Arteriogram of the right arm (ulnar artery injection) shows an AVM with multiple feeders. Multiple, large, early draining veins and aneurysmal lesions are depicted. |
 | Media file 6: Vascular anomalies. Arteriovenous malformation (AVM). Contrast-enhanced magnetic resonance angiogram (MRA) shows a nidus and early draining veins in the forearm. |
 | Media file 7: Vascular anomalies. Arteriovenous malformation (AVM). Pelvic digital subtraction angiogram obtained in a middle-aged women who presented with pelvic pain after childbirth shows an extensive AVM in the sidewalls of the pelvis, with multiple small feeders from both internal iliac arteries. The common and external iliac arteries appear normal (see Image 8). |
 | Media file 8: Vascular anomalies. Arteriovenous malformation (AVM). Image obtained in the patient in Image 7 in a slightly delayed phase of the same arterial injection shows a large area of intense contrast material accumulation (predominantly in the left sidewall of the pelvis) and multiple large draining veins. |
 | Media file 9: Vascular anomalies. Venous malformation (VM). Photograph of a young child shows a facial venous malformation that appears as a bluish skin discoloration without a mass. |
 | Media file 10: Vascular anomalies. Venous malformation (VM). Image shows a small VM in the lower lip, which is characterized by bluish mucosal discoloration and mild soft-tissue swelling. |
 | Media file 11: Vascular anomalies. Sinus pericranii. Axial T2-weighted MRI shows an extracranial hyperintense scalp lesion (VM) with an underlying osseous defect. An area of hypointense signal is present within the epicenter of the calvarial defect; this is consistent with a flow-related signal void. |
 | Media file 12: Vascular anomalies. Venous malformation (VM). Sagittal contrast-enhanced T1-weighted MRI shows a typical VM lesion in the suprapatellar bursa region with easily noticeable patchy contrast enhancement. Although most of the lesion is behind the quadriceps tendon, the lesion appears to extend anteriorly. Patients with VMs may have intraarticular hemorrhage, which may or may not be associated with articular cartilage damage (degenerative hemarthrosis). |
 | Media file 13: Vascular anomalies. Venous malformation (VM). Axial CT image of the pelvis shows a mass that contains multiple phleboliths. Although CT is not the imaging modality of choice for VMs; however, phleboliths and osseous changes, in some cases, are best appreciated on CT scans. |
 | Media file 14: Vascular anomalies. Venous malformation (VM). Direct intralesional contrast injection outlines the vascular anomaly with faint opacification of the draining veins and a few rounded filling defects that represent phleboliths. These imaging features are characteristic of VMs. |
 | Media file 15: Vascular anomalies. Venous malformation (VM). Coronal T2-weighted MRI of the face shows a homogeneously hyperintense lesion in the lower left facial area. On the basis of this appearance alone, the main 2 differential diagnoses should be VM and lymphatic malformation (LM). Because this lesion has obviously intense contrast enhancement, the diagnosis is VM (see Image 16). |
 | Media file 16: Vascular anomalies. Venous malformation (VM). Coronal contrast-enhanced T1-weighted MRI of the face, obtained in the same patient as in Image 15, shows a focal soft-tissue abnormality in the lower left facial area. The lesion enhances significantly and homogenously. |
 | Media file 17: Vascular anomalies. Venous malformation (VM). Contrast-enhanced magnetic resonance angiogram (MRA) shows both arteries and veins in the upper body. A small VM is present in the right axillary area; it consists of a group of small abnormal veins. No abnormalities are seen in the other parts of the vasculature. |
 | Media file 18: Vascular anomalies. Lymphatic malformation (LM). Axial T2-weighted MRI shows an extensive soft-tissue abnormality involving the neck, face, and oropharyngeal structures. The lesion has inhomogeneous hyperintense signal and causes significant airway compression (see Image 19). |
 | Media file 19: Vascular anomalies. Lymphatic malformation (LM). Axial contrast-enhanced T1-weighted MRI obtained in the same patient as in Image 18 shows an extensive LM involving the neck and face. The degree of enhancement is somewhat more than expected for an LM; however, typical enhancement (rings and arcs) is seen, particularly on the left side. Relatively large, rounded, strongly enhancing structures (representing large abnormal veins) are seen; these are common in extensive LMs, although, in some cases, they may be considered evidence of lymphatic venous malformation (LVM) rather than a pure LM. |
 | Media file 20: Vascular anomalies. Lymphatic malformation (LM). Sagittal T1-weighted MRI of the upper body shows a large cystic lesion with a fluid-fluid level, consistent with a macrocystic LM. This condition was previously termed cystic hygroma. These lesions can be easily treated with sclerotherapy. A surgical excision of these lesions is also considered a relatively simple and safe procedure in most cases. |
 | Media file 21: Vascular anomalies. Klippel-Trenaunay syndrome (KTS). Magnetic resonance venogram (MRV) shows a large marginal vein in the lateral aspect of the thigh. The deep veins in both lower extremities appear patent. MRV has replaced the traditional contrast-enhanced venogram in determining the patency of the deep venous system in patients with KTS. This determination is crucial before surgical debulking is performed. |
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Further Reading
Keywords
hemangioma, cavernous hemangioma, venous malformation, vascular malformation, VM, arteriovenous malformation, AVM, lymphatic malformation, Klippel-Trenaunay syndrome, Proteus syndrome, Maffucci syndrome, Parkes-Weber syndrome, capillary malformation, port-wine stain, kaposiform hemangioendothelioma, KHE, arteriovenous fistula, AVF, noninvoluting hemangioma, intramuscular hemangioma, blue-rubber bleb nevus syndrome, BRBNS, glomangioma, sinus pericranii, birthmark, birthmarks
