MRI of ranulas

We reviewed the MRI of 20 patients with a ranula (8 simple and 12 plunging) and ten with other cystic masses in the floor of the mouth and/ or suprahy oid portion of the neck (three haemangiomas, two neuromas, one monomorphic adenoma, one lipoma, two lateral cervical cysts and one dermoid cyst). Hist ological diagnoses were obtained in all cases with the exception of one pre sumed haemangioma. Ranulas were all well-defined, homogeneous masses giving low signal on T1-and markedly high signal on T2-weighted images. While sim ple ranulas were all confined to the sublingual space, plunging ranulas wer e centered on the submandibular space and tended to spill into one or more adjacent spaces. They extended into the sublingual space anteriorly (produc ing a so-called tail sign) in eight of 12 cases and into the parapharyngeal space superiorly in five. Although they sometimes filled a considerable pa rt of the parapharyngeal space, displacement of surrounding muscles or vess els was usually slight, which was thought to reflect the nature of extravas ation pseudocysts. All other cystic masses in our study had one or more MRI finding different from those of ranulas and could be easily differentiated from them.