Hepatic hemangioma in cirrhotics with portal hypertension: evaluation with Tc-99m red blood cell SPECT.
OBJECTIVE
To determine whether extensive shunting associated with portal hypertension (PH) adversely affects the diagnostic accuracy of technetium-99m red blood cell (RBC) single photon emission computed tomography (SPECT) for hepatic hemangioma (HH).


METHODS
Nineteen possible HHs (1.0-11.0 cm in diameter) in 15 cirrhotics with PH were studied with RBC SPECT.


RESULTS
RBC SPECT allowed correct categorization of four HHs (1.5, 2.8, 4.0, and 4.0 cm in diameter) and 13 non-HHs (1.5-11.0 cm in diameter). Two small HHs (1.0 and 1.4 cm in diameter) were "missed." Sensitivity, specificity, and accuracy were 67%, 100%, and 89%, respectively.


CONCLUSIONS
Despite abnormal liver blood flow dynamics due to portosystemic collateralization, RBC SPECT allows reliable identification of HH in cirrhotics with PH. As in noncirrhotics, its major limitation is small lesion size.
Achong
D M
DM
Department of Radiology, New England Medical Center, Boston, MA 02111.
Oates
E
E
D000328:Adult; D000368:Aged; D004912:Erythrocytes; D005260:Female; D006391:Hemangioma / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications*; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013667:Technetium; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D013667:Technetium