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consistent with VaMs, that is, congenital errors in vascular
development. Although they are present at birth, they may
remain dormant and present in later childhood, or adult life.
Histological evaluation of these lesions supports this
classi
fi
cation, with the types of malformations delineated
by the basic type of constituent vessel and the presence or
absence of arteriovenous shunting. They demonstrate
vascular spaces lined with
fl
at, mature epithelium that is
Figure 10
A 4-year-old with hemihypertrophy of left lower extremity, CM, VM, and LM in left lower extremity. Post-surgical resection of lower
leg microcystic LM. Note pelvic involvement with perineal swelling. (b) Axial T2-weighted image with fat saturation shows multiple cysts with
fl
uid
e
fl
uid levels noted deep in the pelvis. (c) Axial post-contrast T1-weighted image demonstrates lack of contrast enhancement in the cysts
con
fi
rming that these represent LMs. (d
e
e) Coronal T2-weighted image with fat saturation shows increased thickness of the subcutaneous fat in
the left thigh (d). Note in
fi
ltration of the subcutaneous fat, and muscle groups by the VM that shows heterogeneous enhancement on coronal
contrast-enhanced T1-weighted images (e). Also note the enlarged/patolous deep venous system.
Figure 11
(a) An 11-year-old female patient with LVM of the tongue, status post-tongue reduction surgery and prior laser treatment. Recurrence
of the blue
e
black small numerous tiny cystic lesions on her tongue. They weep clear lymphatic as well as bloody
fl
uid. (b
e
c) Sagittal T2
Weighted image of the tongue shows increased T2 signal in the intrinsic tongue muscles, that show mild enhancement in contrast-enhanced T1-
weighted sagittal image (c). MRI is helpful in identifying the depth of in
fi
ltration in this super
fi
cial lesion.
A. Tekes et al. / Clinical Radiology 69 (2014) 443
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