Tongue vascular malformation: evaluate extent as well as type. MRI: There is a T2 hyperintense, enhancing lesion in the anterior oral tongue, which measures up to 25 mm. There is also an infiltrative T2 hyperintense, enhancing lesion in the right submandibular space that measures up to 45 mm, as well as a subcentimeter nodular component within the submandibular gland itself. There appear to be septations, flow voids, and perhaps phleboliths within the lesions. An area of high T2 signal in the left supraclavicular fossa may represent an additional lesion or a cluster or lymph nodes, although assessment is limited due to artifacts in this region on some sequences. Otherwise, there is no evidence of significant cervical lymphadenopathy. The thyroid is unremarkable. The osseous structures are unremarkable. The airways are intact. The imaged intracranial structures are unremarkable. MRA: The major venous and arteries structures are intact, without evidence of enlarged feeding arteries or draining veins associated with the tongue and submandibular space lesions. There is no significant steno-occlusive disease in the cervical arteries.
Lesions in the oral tongue and right submandibular space likely represents a low flow vascular malformation, such as a venous malformations. An area of high T2 signal in the left supraclavicular fossa may represent an additional vascular malformation or a cluster or lymph nodes, although assessment is limited due to artifacts in this region on some sequences. 