Accuracy of high-resolution sonography compared with magnetic resonance imaging in the diagnosis of head and neck venous vascular malformations.

AIMS

To evaluate whether modern ultrasound examination helps to establish the diagnosis of head and neck venous vascular malformations (VVMs) and whether it can delineate their full extent.

MATERIALS AND METHODS

Sonographic appearances of 30 head and neck VVMs were assessed for: location, extent, internal architecture, presence of flow and phleboliths. These results were compared with the magnetic resonance imaging (MRI) of the same patients.

RESULTS

The lesions showed well-defined margins (22 of 30, 73%), heterogeneous (30 of 30, 100%) and hypoechoic echo pattern (27 of 30, 90%), with sinusoidal spaces (28 of 30, 93%) and phleboliths (24 of 30, 80%) on grey-scale imaging, and flow signal on Doppler (28 of 30, 93%). For delineating the extent, ultrasound was comparable with MRI in 53% (16 of 30) and inferior to MRI in 47% (14 of 30). Ultrasound did not detect deeper extent, intra-osseous involvement and other clinically occult VVMs.

CONCLUSION

Ultrasound with high-resolution transducers can confidently suggest the diagnosis of head and neck VVMs in up to 90% of cases, and delineate the full extent of some superficial lesions. The major disadvantage is its inability to evaluate intra-osseous involvement and the entire extent of large, deep-seated lesions.