Fig. 9.

A). Radiograph of the right hand reveals a soft tissue mass containing phleboliths in keeping with a venous malformation. B). Ultrasound of the right hand demonstrates slow flow vascular channels within the mass without significant arterialized flow signal. C). Coronal PD-weighted MRI shows an infiltrative slow-flow venous malformation (arrow) in the deep palmar space at the radial side of the hand overlying the second and third metacarpals, extending into the index finger and along the length of the middle finger. The median nerve as well as digital neurovascular bundles to the index and middle fingers were encased by the venous malformation (not shown). D). REACT MIP image reveals no large artery supply or dominant venous drainage of the malformation. REACT MRA demonstrates better signal-to-noise ratio compared to time-resolved CE-MRA. Note the bright lobulated intralesional signal within the vascular malformation due to venous pooling. E. Time-resolved CE-MRA better demonstrates the smaller digital vessels which are obscured on REACT by the large venous / cavernous component of the lesion.