Birnbaum B A, Weinreb J C, Megibow A J, Sanger J J, Lubat E, Kanamuller H, Noz M E, Bosniak M A
Department of Radiology, New York University Medical Center, NY 10016.
Radiology. 1990 Jul;176(1):95-101. doi: 10.1148/radiology.176.1.2191377.
Thirty-seven patients with 69 suspected hemangiomas found by means of computed tomography (CT) and/or ultrasound were studied with both 0.5-T magnetic resonance (MR) imaging and single photon emission CT (SPECT) with technetium-99m-labeled red blood cells. Using a criterion of "perfusion-blood pool mismatch," SPECT readers diagnosed 50 of 64 hemangiomas and all five "nonhemangiomas" (sensitivity, 78% [95% confidence interval, 0.664 - 0.864]; accuracy, 80% [0.69 - 0.877]). Qualitative analysis of lesion signal intensity on T2-weighted spin-echo MR images allowed readers to diagnose 58 of 64 hemangiomas and four of five nonhemangiomas (sensitivity, 91% [0.814 - 0.96]; accuracy, 90% [0.807 - 0.951]). Because of the significantly higher cost of MR imaging and its inability to categorically differentiate hemangiomas from hypervascular metastases, the authors consider SPECT to be the method of choice for diagnosing hepatic hemangiomas. MR imaging should be reserved for the diagnosis of lesions smaller than 2.0 cm and for those 2.5 cm and smaller adjacent to the heart or major hepatic vessels; in such cases MR imaging was found superior to SPECT.
对37例经计算机断层扫描（CT）和/或超声检查发现69处疑似血管瘤的患者，采用0.5特斯拉磁共振成像（MR）和锝-99m标记红细胞的单光子发射计算机断层扫描（SPECT）进行研究。根据“灌注-血池不匹配”标准，SPECT阅片者诊断出64处血管瘤中的50处以及所有5处“非血管瘤”（敏感性78%[95%置信区间，0.664 - 0.864]；准确性80%[0.69 - 0.877]）。对T2加权自旋回波MR图像上病变信号强度进行定性分析，阅片者诊断出64处血管瘤中的58处以及5处非血管瘤中的4处（敏感性91%[0.814 - 0.96]；准确性90%[0.807 - 0.951]）。由于MR成像成本显著更高且无法明确区分血管瘤与高血运转移瘤，作者认为SPECT是诊断肝血管瘤的首选方法。MR成像应保留用于诊断小于2.0 cm的病变以及位于心脏或主要肝血管附近2.5 cm及更小的病变；在这些情况下，发现MR成像优于SPECT。
