Fast-flow lingual vascular anomalies in the young patient: is imaging diagnostic?
OBJECTIVE
To describe the imaging findings (MR imaging and angiography) of high-flow vascular anomalies of the tongue, hemangiomas and arteriovenous malformations (AVMs), with emphasis on the discrepant imaging findings in lingual AVMs.


METHODS
Retrospective review of clinical records, histologic reports and imaging studies of five consecutive patients with high-flow lingual vascular anomalies.


RESULTS
One patient had hemangioma (aged 1 month) and four patients had AVMs (aged 15 months, 6, 24, and 33 years). Diagnosis was made on the basis of histology in four lesions and was based on typical clinical history in one lesion. MR imaging and angiographic findings of the hemangioma were typical, but similar findings of focal hyperintense mass on T2-weighted images and angiographic stain were seen in three AVMs (patients aged 15 months, 6 and 33 years). On angiography, there was no nidus or direct arteriovenous (AV) shunting in one AVM (patient aged 15 months). The fourth AVM had typical MR imaging and angiographic findings.


CONCLUSIONS
The imaging findings in lingual AVMs can be atypical or inconclusive and can mimic hemangiomas, especially in the young patient. Since treatment depends on accurate diagnosis, biopsy may be necessary for lesions with inconclusive imaging findings.
Khong
Pek-Lan
PL
Department of Radiology, Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
Burrows
Patricia E
PE
Kozakewich
Harry P
HP
Mulliken
John B
JB
D000328:Adult; D001165:Arteriovenous Malformations / Q000175:diagnosis / Q000628:therapy; D001900:Boston; D002648:Child; D004621:Embolization, Therapeutic; D005260:Female; D006391:Hemangioma / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009367:Neoplasm Staging; D011859:Radiography; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000628:therapy; D014059:Tongue / Q000098:blood supply* / Q000000981:diagnostic imaging; D014060:Tongue Diseases / Q000175:diagnosis* / Q000628:therapy; D014062:Tongue Neoplasms / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome; D014680:Veins / Q000002:abnormalities