Case#16

History: Young female patient with painful forearm, no skin lesions. Radiographs were negative. MRI was obtained (see below).

Imaging Studies:

  • MRI: T1 weighted and fat-saturated post-contrast here
  

1st MR image is a T1 weighted axial image through the proximal forearm (near the elbow) showing a heterogeneous mass-like lesion involving the muscle groups. The bright portion of the malformation represents fatty tissue, and gray color portion (minimally brighter than muscle) represent a vascular portion of the malformation. 2nd image is a fat-suppressed T1 weighted image following intravenous contrast injection demonstrating a typical contrast enhancement pattern in association with suppression of the fatty signal.  This is a very nice example to demonstrate the fact that significant number vascular anomalies (both high- and low-flow malformations) demonstrate increased fatty tissue.

 

This is a radiographic image acquired during sclerotherapy. Contrast injection into the malformation outlines the malformation with rounded filling defects representing phleboliths. Management in these patients does not differ from other low-flow venous or lymphatic lesions. This patient was successfully treated with sclerotherapy. 

 

 

 

 

 

Diagnosis: Venous Malformation ("Cavernous hemangioma") with a fatty component

 

 

                                                                            

 

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