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Hepatic Hemangioma on SPECT Myocardial Perfusion Imaging.
Clinical Nuclear Medicine
|April 25, 2018
Summary
Extracardiac uptake on SPECT MPI can mimic pathology. In a renal transplant patient, this uptake was caused by liver herniation with a hemangioma, not infection or tumor.
Area of Science:
- Nuclear medicine
- Radiology
- Cardiology
Background:
- Myocardial perfusion imaging (MPI) using SPECT can be confounded by extracardiac radiotracer uptake.
- This uptake can mimic various pathologies, including neoplasms, infections, and inflammatory conditions, potentially leading to misdiagnosis.
Observation:
- A 38-year-old woman with end-stage renal disease undergoing SPECT MPI for renal transplant evaluation presented with focal extracardiac uptake.
- The uptake was located adjacent to the diaphragmatic right ventricle, raising concern for infection or malignancy.
Findings:
- Computed tomography (CT) revealed the focal uptake was due to a herniated liver segment containing a hemangioma.
- This finding highlights a rare cause of extracardiac activity on SPECT MPI.
Implications:
- Accurate interpretation of SPECT MPI requires consideration of non-cardiac causes of radiotracer uptake.
- CT is crucial for characterizing incidental extracardiac findings on MPI.
- Understanding such artifacts is vital for correct preoperative risk stratification and diagnosis.
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