Images

Doctor's Information

Name : Hamidreza
Family : Haghighatkhah
Affiliation :Radiology department,ShohadaTajrish Hospital,SBMU
Academic Degree : Associate professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Afarin Sadeghian

Case Section

Muskuloskeletal System

Patient's Information

Gender : Male
Age : 20

Clinical Summary

20-year-old man presented with a palpable mass in hand and forearm regions along feeling thrill in physical examination

Imaging Findings

MR images demonstrate multiple tubular structures that are high on T2-weighted sequences with areas of signal voids.Contrast-enhances images show a large cluster of a dilated and tortous enhancing vesseles without a intervening mass.All above findings are most compatible with a high-flow vascular malformation.

Differential Diagnosis

-----------------

Final Diagnosis

Congenital arteriovenous malformation (AVM)

Discussion (Related Text)

AVM's are congenital vascular lesions that arise secondary to a developmental defect in the vascular system in the 4-6th gestational weeks. There is a direct connection between the artery and the vein, but no capillary bed exists. AVM's contain tortuous dilated feeding arteries and draining veins. AVM's can cause cosmetic defects, and compression to the peripheral nerves leading to pain and functional disorders. Eventually, this abnormal hemodynamic cause steal phenomenon, venous hypertension and ischemic ulcers, dermatitis due to venous stasis and progress to gangrene, dangerous bleeding and cardiac insufficiency. Imaging studies play an important role in differential diagnosis. Angiography is the gold standard technique in precise diagnosis and also it is a very important tool in planning the therapy. MRI is especially valuable for evaluating the extent of the lesion and for detecting the relationship between the lesion and the adjacent anatomic structures.

References

Gluteal lesions: imaging finding,ECR 2014

end faqaq