Hepatic hemangioma with normal angiograms. Three case reports
W D Davis1, W A Ferrante, R H Tutton
1Department of Surgery, Ochsner Clinic, New Orleans, LA 70121.
JAMA
|February 16, 1990
Summary
Diagnosing liver hemangiomas is possible noninvasively with high accuracy using imaging like Technetium Tc 99m-labeled red blood cell scanning and dynamic computed tomography. Angiography is often unnecessary and can be misleading for these symptomatic liver lesions.
Area of Science:
- Hepatology
- Diagnostic Imaging
- Radiology
Background:
- Cavernous hemangiomas are the most common benign liver tumor.
- Symptomatic cases require accurate diagnosis for appropriate management.
- Traditional diagnostic methods like angiography can be invasive and inconclusive.
Observation:
- Three cases of symptomatic liver hemangioma with normal angiograms are presented.
- Literature review indicates noninvasive diagnostic capabilities for liver hemangiomas.
- Specific imaging modalities show high accuracy in diagnosis.
Findings:
- Technetium Tc 99m-labeled red blood cell scanning offers high specificity.
- Dynamic computed tomography (CT) demonstrates sensitivity for small lesions.
- Combining Tc 99m-RBC scanning and dynamic CT achieves over 90% diagnostic accuracy.
- Magnetic resonance imaging (MRI) is also a sensitive and specific diagnostic tool.
- Angiography proved misleading in the reported cases, questioning its utility.
Implications:
- Noninvasive imaging techniques are preferred for diagnosing liver hemangiomas.
- Accurate diagnosis via imaging can guide treatment decisions, including resection.
- Over-reliance on angiography for liver hemangioma diagnosis should be reconsidered.
