Hepatic hemangiomas: pitfalls in scintigraphic detection.

Area of Science:

• Hepatology
• Diagnostic Imaging
• Interventional Radiology

Background:

• Solitary hepatic lesions are common clinical findings.
• Radionuclide imaging (scintiscans, flow studies, blood pool images) is typically used to assess lesion vascularity.
• Hepatic hemangiomas are benign vascular tumors of the liver.

Observation:

• Three patients with angiographically proven hepatic hemangiomas were evaluated.
• Radionuclide techniques failed to detect the vascularity of these hemangiomas.
• Sluggish blood flow within hemangiomas may be the reason for missed detection.

Findings:

• Radionuclide imaging may underestimate or miss the vascularity of hepatic hemangiomas.
• Arteriography can effectively demonstrate the vascularity of hepatic hemangiomas.
• Hepatic hemangiomas can present a diagnostic challenge for conventional imaging.

Implications:

• Clinicians should consider angiography for evaluating solitary hepatic tumors before percutaneous liver biopsy.
• Failure to identify hemangioma vascularity can lead to misdiagnosis and potential complications.
• Performing angiography prior to biopsy can prevent life-threatening bleeding events, such as exsanguination.