Fig. 11
From: Masses of developmental and genetic origin affecting the paediatric craniofacial skeleton
Venous vascular malformation (VVM) in a 12-year-old girl complaining of increasing left cheek swelling causing major facial asymmetry and dental malocclusion. a Grey-scale ultrasound (upper image part) and corresponding Doppler US (lower image part) show hypoechoic and infiltrative mass with poor vascularisation. b Axial low-dose CT (bone window) shows shortened and remodelled left ascending ramus of the mandible (arrowhead) and increased distance (arrow) between the left ascending ramus of the mandible and posterior wall of the left maxillary sinus, compatible with a slow-growing lesion. c This increased distance is also clearly seen on the three-dimensional CT VR reconstruction. STIR (d) and T2 (e) images show a hyperintense mass with multiple small phleboliths (small, dark, rounded areas) situated within Bichat’s fat (arrows). f Contrast-enhanced axial fat-saturated T1 shows partial, progressive, centripetal lesion enhancement (arrowhead) characteristic of a VVM