Effect of lesion size in the diagnosis of hepatic hemangioma with Tc-99m erythrocyte scintigraphy

Abstract

AimDiagnosis of the hepatic hemangiomas is sometimes difficult by means of computed tomography (CT) or ultrasound (USG). This kind of lesions can be accurately identified by Tc-99m labeled erythrocyte -red blood cell (RBC) imaging. However there are controversial results about small lesions (<1.5 cm). Aim of this study is to evaluate the effect of lesion size in the diagnosis of liver hemangioma by using Tc-99m labeled RBC scintigraphy.MethodsForty-two patients who had liver lesions with the suspicion of hemangioma were retrospectively evaluated. Tc-99m RBC scintigraphy results of the patients were compared with 3-24 months clinical or USG follow-up or morphological imaging methods (dynamic computerized tomography or magnetic resonance imaging (MRI)).ResultsTwenty seven of 42 patients had follow-up and their diagnosis was confirmed. Sensitivity, specificity, accuracy, positive and negative predictive value of Tc-99m RBC scintigraphy according to follow up results were 92%, 66%, 89%, 96% and 50%, respectively. Two false negative lesions were smaller than 1.5 cm (10 mm, 13 mm). One of the 3 patients with small lesion who came for follow-up had true positive result. Existence of small lesions in the study made the specificity and negative predictive value decreased.ConclusionAlthough small sized (<1.5 cm) hemangiomas sometimes can also be visualized with Tc-99m RBC scintigraphy, this technique is very sensitive especially for large lesions.

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