Differentiation of focal intrahepatic lesions with /sup 99m/Tc-red blood cell imaging
The appearance of focal hepatic lesions on /sup 99m/Tc-sulfur colloid images is nonspecific. As it is important to distinguish hemangiomas from other lesions prior to biopsy, a prospective study was performed using /sup 99m/Tc-labeled red blood cells. Dynamic perfusion and delayed blood-pool images (1-2 hours) were obtained and lesion activity categorized as increased, equal, or decreased compared with the liver. Of 21 patients studied, 9 (43%) had one or more hepatic hemangiomas, and 8 of these 9 patients (89%) demonstrated increased blood-pool activity. The 12 nonhemangiomatous lesions consisted of 7 metastatic tumors, 2 hepatomas, 1 cirrhotic nodule, and 2 hepatic cysts. None of these 12 patients had increased activity on delayed blood-pool images. Early dynamic images of hepatic hemangiomas demonstrated variable activity (vascularity) and were not useful in differentiating hemangiomas from other lesions. Sensitivity was 89% and specificity 100%. Although liver enzymes are usually normal with hepatic hemangiomas, they may also be normal in metastatic disease. The authors recommend that delayed blood-pool imaging be performed prior to biopsy, particularly in patients without a known primary tumor or those with normal liver enzyme levels.
- Research Organization:
- Henry Ford Hospital, Detroit, MI
- OSTI ID:
- 6148656
- Journal Information:
- Radiology; (United States), Vol. 146:3
- Country of Publication:
- United States
- Language:
- English
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/sup 99m/Tc red blood cell scintigraphy in evaluating focal liver lesions
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