 The topic for my paper presentation is MRI of the arterial venous malformation of the scalp. Vascular anomalies include broad spectrum of lesions involving all parts of the body, especially the head and neck. Vascular tumors include hemangioma, hemangioma, buccaloma, stopgrid angiomas and sarcomas. Slow-followed flow muscular malformations include capillary malformations, venous malformations, lymphatic capillary and venous malformations, capillary lymphatic and venous malformations. High-flow malformations include AVF and arterial venous malformations, AVM. AVMs are rare congenital vascular malformations account for only 1.5% of all vascular anomalies. However, 50% of them are noted in the oral and medial facial region and it usually results from the birth defects of the vasculature. Usefulness of MRI in the diagnosis of vascular lesions on the scalp is highlighted in my presentation. On MRI, AVMs will appear as enlarged vascular channels associated with diluted feeding and brain vessels that appear as flow voids without any parent diamond staining. A discrete soft tissue mass is typically absent. However, perillational signal abnormalities, soft tissue enhancement and or mass-like features are some atypical findings which may be seen and that make these lesions more difficult to differentiate from the hemangioma. AVM is an irregular direct connection between arteries and veins. Normally, arteries and veins are indirectly connected within between the networks of very small blood vessels called as capillaries. These capillaries are important intermediaries which serve to decrease the pressure of the blood and provide a medium for nutrient or waste exchange between the blood and cells. Thus, when there is a direct communication, as in AVMs, it makes them more prone to spontaneous bleeding. There are rare congenital vascular lesions and can occur anywhere in the body. However, the most common location is in the face and maxillofacial region constituting 50%. These can be life-threatening because of potential massive hemorrhage and thereby are the most challenging lesions to manage. Thereby, diagnostic imaging is very necessary for anatomical assessment and analysis of the NIDIS, the site of arterial venous trending and based on the imaging findings, integrated surgical and non-surgical interventions can be done for treatment including sclerotherapy and vescular or percutaneous embolization, surgical excision or some combination of these modalities. My case report is a 14-year-old boy which was effort to our department for the evaluation of a slowly progressive local left-sided forehead swelling since childhood and a recent onset of another smaller swelling which was at the middle side of left eyebrow. On clinical examination, the swelling was soft, painless and non-tender with reddish over-line skin and on palpation, bruise was there. There was however no differential warmth in the area. Patient was also given a history of periodic eye bleed and no other significant medical history was reported by the patient and the parents. As you can see here, this was the main swelling for which the patient was referred for evaluation for and on the left side of the forehead and this was the smaller swelling on the medial side of the left eyebrow. MRI findings was this ill-defined tangle of serpidinous vessels which we can see here in the subcutaneous plane overline the left frontal temporal scalp region which is the major nidus and a smaller tuft which is organizing here with the possible nidus formation can also see. The major feeder to this nidus is this left ophthalmic artery which is the branch of left IC as we can see here and contributing to the AVM. On this 3D VR-NJ image, we can see this was the bigger nidus, major nidus which is fed by the superficial temporal artery on left side which is a branch of external carotid artery and we can also see the early draining veins which are the bilateral facial veins which are also constituting this AVM. Here we can see the intra-orbital component of the AVM with the bilateral supereithelmic veins giving prominent flow void and contributing to the AVM. Here we can see again in this 3D ampere-NJ image bilateral enlarged supereithelmic veins which are constituting the draining veins for the scalp AVM. Thereby concluding my presentation, AVMs are the fast flow vascular malformations they consist of anomalous capillary beds between the arterial and venous system and thereby causing the shunting of blood. They are the most aggressive form of vascular malformation which can lead to significant deformity and functional impairment. Fast flow vascular malformations generally become evident during childhood and puberty however some cases have been seen which present very late and are incidentally detected in addition there can also be hereditary diseases in which there is increased risk of AVM formation like HHD and VHL disease. AVM on the face or scalp is an abnormal facial connection between the feeding arteries, early draining veins and no intravening capillary bed generally in the subcutaneous layer and the draining veins are crossly dilated, they are tortuous and they can show variceal dilatation also. The dilatation of vascular channels often results in the deformity of the scalp and face which is usually not life threatening but they cause substantial cosmetic and social disturbances because the face and scalp have a rich arterial network which is fed by branches of external carotid artery. The arterial system that supplies AVM frequently is multiple and very complex in particular the facial lesions which are around the midline are being fed by bilateral arteries whereas the forehead lesions are frequently supplied by the supraorbital branch of the ophthalmic artery as well as by the branches of the external carotid artery. In our case also there was a ferding artery by the superficial temporal artery and also by the ophthalmic artery. MRA thereby can be used in an excellent technique in the diagnosis of these vascular malformations either by itself or before angiography. It shows a good depiction of the vascular structure permitting the differentiation between the high flow and the low flow lesions. High flow lesions will show typical signal flow voids both in T1 weighted images with the appearance of the serpentine flow voids of these vessels. MRA is also able to identify the kind of flow that is high flow or low flow and also the origin of these vessels that is external carotid artery mostly and utility of the MRA also lies in the valuation for any intracranial component of the scalp. Thanks.