Blood-pool studies of the liver. Diagnostic patterns exist in cavernous haemangioma

Hepatic haemangioma is the most common vascular abnormality of the liver occurring in 0.4% to 7% of reported autopsy series. Its diagnosis is critical, as biopsy of these lesions can lead to catastrophic results owing to uncontrolled haemorrhage. Hepatic angiography is normally used for diagnosis. Previous reports of attempts to confirm the diagnosis by non-invasive means such as ultrasound and computed tomography (CT) have shown these tests to be non-specific. The usefulness of the patient's own red blood cells labelled with technetium-99m (99mTc RBC) in the non-invasive diagnosis of hepatic haemangioma was investigated. After the intravenous injection of the isotope, flow, early static, and delayed static views were obtained. A flow study demonstrating decreased perfusion and a late blood-pool study showing local blood volume markedly greater than that of the normal liver were characteristic of haemangioma. 99mTc RBC studies are useful in the evaluation of focal defects in the liver when cavernous haemangioma is suspected. A diagnostic pattern is present in patients with cavernous haemangioma.