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Topic

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Lingual vein

The lingual vein is the principal venous drainage vessel of the tongue and floor of the mouth. It originates from tributaries within the dorsum and margins of the tongue, including the deep lingual vein and the dorsal lingual veins, before draining into the internal jugular vein either directly or via the facial vein. The lingual vein runs alongside the lingual artery and the hypoglossal nerve (CN XII), forming an important component of the vascular neurobundle of the tongue.

It plays a key role in venous return from lingual musculature and mucosa, contributes to the valveless venous plexus of the head and neck, and provides potential routes for spread of infection or tumor metastasis.

Synonyms

  • Venous drainage of tongue

  • Vena lingualis

  • Lingual venous plexus

Function

  • Drains venous blood from the tongue muscles, mucosa, and floor of mouth

  • Maintains venous return to the internal jugular vein

  • Contributes to facial venous plexus, providing collateral drainage

  • Can serve as a pathway for infection spread due to valveless venous channels

MRI Appearance

T1-weighted images (non-contrast):

  • Lingual vein appears as a signal void (hypointense linear structure) within the tongue and floor of mouth due to flowing blood

  • May not be well seen unless enlarged or thrombosed

T2-weighted images:

  • Appears as a flow void in normal conditions

  • Thrombosed lingual veins may appear hyperintense, helping to identify venous pathology

MRA (Magnetic Resonance Angiography):

  • MR venography sequences (time-of-flight or contrast-enhanced) demonstrate the course, caliber, and venous tributaries

  • Normal lingual veins enhance as well-defined venous channels

  • Useful for detecting venous malformations, obstruction, or collateral circulation

T1 Post-Contrast (MR Venography):

  • Contrast-enhanced imaging demonstrates homogeneous enhancement of the lingual vein

  • Abnormalities (e.g., venous thrombosis, tumor invasion, vascular malformations) appear as filling defects or irregular enhancement

CT Appearance

Non-contrast CT:

  • The lingual vein is generally not well visualized unless thrombosed (appearing as a hyperdense tubular structure)

  • Surrounding fat planes in the floor of mouth may outline its location

CT Angiography (CTA / CTV):

  • Contrast-enhanced CT venography demonstrates the lingual vein as an enhancing venous channel, running parallel to the lingual artery

  • Excellent for evaluating venous patency, thrombosis, varices, or venous malformations

  • Useful in preoperative planning for oral, maxillofacial, and vascular surgery

MRI images

Lingual vein mri axial image -img-00000-00000