Table 3 Distinguishing imaging features among vascular malformations of the sublingual and submandibular spaces
Lymphatic | Venous | Arteriovenous | |
|---|---|---|---|
CT | -Uniloculated or multiloculated cyst with variably enhancing septa | -Heterogeneous, enhancing infiltrative lesion -Phlebolith(s) are nearly pathognomic if present | -Enlarged artery and vein with shunting |
MR | -Uniloculated or multiloculated lesions with high T2 signal -Fluid-fluid level may be present | -Ill-defined lesions with variable T2 signal depending on venous vessel calibre -Small = more solid with lower T2 signal -Large = flow voids | -Serpiginous flow voids representative of arteries and draining veins |
US | -Variable echogenicity depending on size of cystic components | -Mixed echogenicity components -Slow monophasic venous flow | -Enlarged feeding artery and dilated veins with arterialised flow -Stacked, biphasic waveform |
Site | -Submandibular space -Posterior cervical space | -Deep neck spaces -Maxilla or mandible | -Rare in this region -Usually involves lingual artery |