Focal hyperemia on RBC blood-flow imaging. A scintigraphic marker of arterioportal venous shunting in hepatic cavernous hemangiomas?
OBJECTIVE
To investigate the significance of increased perfusion associated with some hepatic hemangiomata during radionuclide blood volume imaging.


METHODS
Immediate dynamic planar projections and delayed SPECT imaging of a hepatic lesion were obtained after the administration of Tc-99m-labeled RBC. Scintigraphic data were compared with X-ray CT, contrast angiography and postresection histopathology.


RESULTS
A surgically proven, cavernous hemangioma with typical findings on delayed radionuclide blood-pool imaging showed markedly increased perfusion by scintigraphy. This correlated with arterioportal venous shunting (AVPS) on contrast angiography.


CONCLUSIONS
Increased perfusion on radionuclide blood-volume imaging of hepatic hemangiomata may be a scintigraphic marker of AVPS. This may serve to identify patients with increased risk for spontaneous rupture or may identify them for the development of portal hypertension.
Dwamena
B A
BA
Department of Internal Medicine Nuclear Medicine, University of Michigan Medical Center, Ann Arbor 48109-0028, USA.
Belcher
K K
KK
Dasika
N
N
Frey
K A
KA
D001810:Blood Volume; D004912:Erythrocytes; D005260:Female; D006392:Hemangioma, Cavernous / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D012307:Risk Factors; D013670:Sodium Pertechnetate Tc 99m; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m