• CLINICAL RESEARCH •
Role of SPECT/CT in diagnosis of hepatic hemangiomas
Jian-Guo Zheng, Zhi-Ming Yao, Chong-Ye Shu, Ying Zhang, Xia Zhang
PO Box 2345, Beijing 100023, China World J Gastroenterol 2005;11(34):5336-5341
www.wjgnet.com World Journal of Gastroenterology ISSN 1007-9327
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Jian-Guo Zheng, Zhi-Ming Yao, Department of Nuclear Medicine,
Beijing Hospital, Beijing 100730, China
Chong-Ye Shu, Imaging Center, Central Hospital of Siping City,
Siping 136000, Jilin Province, China
Ying Zhang, Department of Nuclear Medicine, People’s Hospital
in Liaocheng City, Liaocheng 252000, Shandong Province, China
Xia Zhang, Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu 610041, Sichuan Province, China
Correspondence to: Xia Zhang, Department of Anesthesiology,
West China Hospital, Sichuan University, Chengdu 610041, Sichuan
Province, China. email@example.com
Telephone: +86-28-85422518 Fax: +86-28-85422518
Received: 2005-02-17 Accepted: 2005-04-02
AIM: To investigate the role of SPECT/CT in the diagnosis
of hepatic hemangiomas whose anatomical positions are
not ideal, situated adjacent to the heart, the inferior cava,
hepatic vessels or abdominal aorta, etc.
METHODS: The hepatic perfusion, blood pool, and fusion
imaging were carried out using SPECT/CT in 54 patients,
who were suspected for hepatic hemangiomas. When
the anatomical positions were not ideal, the diagnosis
was difficult by SPECT only. So the information of computed
tomography (CT) was applied to help in diagnosing. The
results were recorded as hemangiomas or not.
RESULTS: Of the 54 patients, 31 patients were diagnosed
as suffering from hepatic hemangiomas. The anatomical
positions of eight patients’ hepatic hemangiomas (25.81%)
were not ideal. Among these lesions of the eight patients,
three patients’ hepatic lesions were located near to the
abdominal aorta, one to the heart, and four to the inferior
cava. In addition, six abnormal radioactivity accumulation
regions, adjacent to the heart and inferior cava, with the
help of CT, were confirmed to be the imaging of inferior
cava other than hepatic hemangiomas.
CONCLUSION: When the anatomical positions of hepatic
hemangiomas are not good enough for diagnosis, the
fusion imaging of SPECT/CT is a simple and efficient method
for differential diagnosis.
© 2005 The WJG Press and Elsevier Inc. All rights reserved.
Key words: SPECT/CT; Hepatic hemangiomas; Scintigraphy
Zheng JG, Yao ZM, Shu CY, Zhang Y, Zhang X. Role of
SPECT/CT in diagnosis of hepatic hemangiomas. World J
Gastroenterol 2005; 11(34): 5336-5341
The diagnosis of a number of atypical hepatic hemangiomas
in cross-sectional images is also very difficult. Moreover,
when the tumor is present in staging or in the follow-up of
oncological patients, the differentiation of hepatic hemangioma
from hepatic metastatistic diseases is a common clinical question.
Contrast-enhanced magnetic resonance imaging (MRI) and
multiple helical computed tomography (CT) is also limited
to distinguish focal hepatic lesions in some ways. Contrast-
enhanced ultrasonography (US) is helpful to confirm the
characterization of the focal liver disease. However, the
diagnosis is associated with the experience of the surgeon.
As regards single-photon emission computed tomography
(SPECT), when the anatomical positions of hepatic
hemangiomas were not ideal, for example, close to the heart,
inferior cava or main hepatic vessels, etc., it may cause some
difficulty for diagnosis, because the radioactivity of the 99mTc-
labeled RBC is centralized in the heart, inferior cava, abdominal
aorta and main hepatic vessels, and the radioactivity of
blood pool is existing from the start. Thus, it is difficult to
detect hepatic hemangioma, which is close to the above-
mentioned structure, especially tiny ones.
A method, SPECT/CT, which can localize the hepatic
lesions accurately will be helpful to diagnose this kind of
hepatic hemangioma. The imaging of 99mTc-labeled red blood
cell scintigraphy through SPECT is non-invasive and highly
specific, able to avoid invasive method or biopsy. Meanwhile,
when the anatomical position is not ideal, close to heart,
inferior cava, main hepatic vessels, abdominal aorta, upside
of right kidney, the diagnosis accuracy is improved owing
to the locating function of the CT.
MATERIALS AND METHODS
TERIALS AND METHODS
TERIALS AND METHODSTERIALS AND METHODS
TERIALS AND METHODS
Fifty-four patients who were suspected for hepatic hemangiomas
found by US, CT, and or MRI, and were examined by
SPECT/CT from April 26, 2001 to July 15, 2004 in Beijing
Hospital. Their average age was 49.15±13.78 years. Among
them, 31 were men with an average age of 50.38±15.36 years;
23 were women with an average age of 47.36±11.22 years.
The oldest was 91 years old and the youngest was 27 years old.
First, the patients were required to take 400 mg of perchlorate
potassium. Thirty minutes later, 10 mg of pyrophosphate
dissolved in 2 mL of water for injection was administered
into one patient. Thirty minutes later again, 740 MBq of
Na99mTcO4 was also administered intravenously by bolus
injection. The imaging was obtained using the SPECT/CT
(Hawkeye, General Electronic Medical System).
inferior cava passes by the liver, and enters right heart, a
great majority can form a round-like radioactive accumulation
region on the brim of the liver (Figure 2C). Under the
condition, with the help of CT, the radioactive concentration
region may be seen under the heart, link with the inferior
cava and out of the liver. If it is, then hepatic hemangioma
can be excluded. If it is not and the, the focus is in the liver,
the diagnosis of hepatic hemangioma could be made.
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Science Editor Guo SY Language Editor Elsevier HK
Zheng JG et al. Applying SPECT/CT in the hepatic haemangiomas 5341