MedPix® Patient Chart - Case No: 4347 :: - Review Images

37 year old mant who had an incidental mass seen in the liver on MRI. He is asymptomatic.

- Review Images for PT: 4347

Early flow and blood pool images show focal area of decrease radiotracer activity in the right lobe of the liver. Delayed images show a large round focal area of intense increase in radiotracer uptake. This corresponds to the previously seen area of photopenia.
MRI images on T1 shows a large mass with heterogeneous signal intensity and T2 shows the mass to have high signal intensity.

- Review Images for PT: 4347

Differential includes hemangioma, hepatoma, and angiosarcomas. Findings are consistent with Hemangioma of the liver. Criteria for diagnosis of a hemiangioma on Technetium-99m labeled red blood cell (Tc99m-RBC) scan require the liver mass to have increase activity on 1 or 2 hour delayed imaging. Blood flow images usually show decrease uptake but can show early uptake. Large hemangiomas can show heterogeneous uptake.
Diagnosis of a hemiangioma on Tc-99m RBC scan has a very high positive predictive value (approaching 100%). Rare false positives have been reported for hepatomas and angiosarcomas. False negative studies are also rare and may be a result of fibrosis or thrombosis. Planar imaging can demonstrate hemangiomas from 3 cm and greater. Multiple headed SPECT can detect hemangiomas from 1.5 cm and greater.


Ref: Thrall, James, Nuclear Medicine: The Requisites, 1995, pp 204-210

- Review Images for PT: 4347

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