Farlow D C, Chapman P R, Gruenewald S M, Antico V F, Farrell G C, Little J M
Department of Nuclear Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
World J Surg. 1990 Jul-Aug;14(4):463-7. doi: 10.1007/BF01658668.
Noninvasive diagnosis of cavernous hemangioma of the liver is an important step in the investigation of patients with focal hepatic lesions since biopsy may result in life-threatening hemorrhage. To determine the diagnostic accuracy of 99m-technetium red blood cell (99mTc-RBC) imaging with tomography, 50 patients with various types of focal liver lesions were studied. Thirty-two patients had 45 hemangiomas and 7 other benign lesions while 18 patients had either primary (n = 8) or secondary (n = 10) hepatic malignancies. Tomographic imaging identified 12 more hemangiomas than planar imaging, improving sensitivity from 53% to 80%, and was found most useful for detection of smaller lesions (mean size, 2.1 cm). Specificity for hemangiomas was 100% with all lesions greater than 1.9 cm showing the characteristic scintigraphic pattern of blood-pooling on delayed images. There was excellent agreement between 2 independent observers concerning interpretation of tomographic images (89% for the hemangioma group and 100% for other patients). Therefore 99mTc-RBC scintigraphy with tomography is an accurate diagnostic technique in the investigation of cavernous hemangiomas. Its major value resides in its ability to distinguish hemangiomas from other types of hepatic pathology.
肝海绵状血管瘤的无创诊断是局灶性肝病变患者检查中的重要一步，因为活检可能导致危及生命的出血。为了确定99m锝红细胞（99mTc-RBC）断层扫描成像的诊断准确性，对50例患有各种类型局灶性肝病变的患者进行了研究。32例患者有45个血管瘤和7个其他良性病变，而18例患者有原发性（n = 8）或继发性（n = 10）肝恶性肿瘤。断层扫描成像比平面成像多发现12个血管瘤，灵敏度从53%提高到80%，并且发现对较小病变（平均大小，2.1 cm）的检测最有用。血管瘤的特异性为100%，所有大于1.9 cm的病变在延迟图像上均显示出血池的特征性闪烁图型。两位独立观察者对断层扫描图像的解读之间存在极好的一致性（血管瘤组为89%，其他患者为100%）。因此，99mTc-RBC断层扫描闪烁显像是肝海绵状血管瘤检查中的一种准确诊断技术。其主要价值在于能够将血管瘤与其他类型的肝脏病变区分开来。
