haemangioma in base of the tongue
DESCRIPTION
TRANSCRIPT
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HAEMANGIOMA IN BASE OF THE TONGUE
22 yr old with H/o oral cavity bleeding
( spontaneous ) The bleeder was
ligated under GA . Lesion was found at base of the tongue. ( ? Haemangioma
Left side base of the tongue).
MERCURY IMAGING INSTITUTE SCO 172-173 SEC 9C CHANDIGARHMERCURY IMAGING CENTRE SCO 16-17 SEC 20D CHANDIGARH
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Practical Ready Reference points
• VASCULAR MALFORMATIONS ARE EITHER
1. Arterial2. Venous3. Capillary4. Lymphatic
• Phleboliths are common in venous malformations.
• Size of the vascular malformations may change with trauma, infection , endocrine changes ( puberty,pregnancy).
• Involution / regression – common with capillary haemngioma’s
• MR angiogram demonstrates feeding arterial tree in High flow malformations ( poor demonstrations in low flow malformations).
• Signal voids are appreciated with serpentine pattern of vasculature in the basic MR sequences especially in case of Arterial malformations.
• Venous malformations are the common lesions in the oral cavity. May be associated with blue rubber bleb syndrome.
• Maffucci’s syndrome – Associated with multiple enchondroma’s
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Brief about haemangioma’s............
• Vascular malformation of the tongue comprise significant proportion of angiodysplastic lesions of the head/ neck region ..... Haemangioma of the base of the tongue per se is rare lesion.
• Phleboliths are appreciated on conventional imaging / plain CT study.
• Lobulated lesion is appreciated with possible mass effect .
• Before intervention – Cross sectional imaging with CT/MR should be done .
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Present case....................
• Lobulated mass with epicentre on the left side of the tongue in young adult male . H/o profuse bleeding – Bleeder ligated under GA.
• MR study – Signal voids appreciated in the core of the lesion with Dilated prominent lingual artery with ramifications extending into the core of the lesion. No frank dilated draining veins appreciated .
• Findings are corroborative with High flow vascular malformations .
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SIGNAL VOIDS IN THE SUBSTANCE OF
THE LESION
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Dilated prominent lingual branch of the left ECA with
further arterial Ramifications supplying the
lesion
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LEFT SIDE LINGUAL BRANCH OF ECA
RT SIDE LINGUAL BRANCH OF ECA
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The lingual artery is one of the branches of the external carotid artery and supplies the oral floor and tongue.Summary•origin: branch of the external carotid artery at the level of the C3•course: towards hyoid, then loops down towards the tongue•supply: oral floor and tongue•termination: tongue•key relationships: loop is crossed by the hypoglossal nerve
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DISPROPORTINATLE LARGE LINGUAL BRANCH OF THE LEFT SIDE ECA.
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RAMIFICATIONS AS DEMONSTARTED WITH REFORMATED IMAGES.
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LINGUAL BRANCH OF LEFT SIDE ECA
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REFORMATION
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To conclude................................
• MR angiogram demonstrates Feeding arterial tree more so in High flow vascular malformations.
• Signal voids , Lobulated outline , serepentine pattern of core vessels , Feeding arteries , draining veins – Help in assessing / categorising the vascular malformation.
• Regression / involution/ augmentation of size has to be assesed ( temporal evolution).