Perfusion and blood-pool scintigraphy in the evaluation of head and neck hemangiomas

We investigated the sensitivity and specificity of perfusion and blood-pool scintigraphy in the detection of head and neck hemangiomas and evaluated their histopathologic types.

Perfusion and blood-pool scintigraphy with 99mTc-red blood cells (RBCs) or 99mTc-human serum albumin combined with DTPA (HSA-D) were used to evaluate 51 head and neck lesions clinically suspected of being hemangiomas in 48 patients. Thirty-three of the 51 lesions were subsequently histologically confirmed to be hemangiomas, whereas the remaining 18 were histologically diagnosed as other lesions.

Perfusion and blood-pool scintigraphy correctly diagnosed 30 of 33 hemangiomas as being hemangiomas but could not detect the remaining 3 hemangiomas. Perfusion and blood-pool scintigraphy correctly diagnosed 12 of 18 lesions as nonhemangiomas, but the remaining 6 lesions were misdiagnosed as hemangiomas. Thus, the sensitivity for detecting hemangiomas was 91%, with a specificity and accuracy of 67% and 82%, respectively. Twenty-five (89%) of 28 cavernous or venous hemangiomas demonstrated normal activity on the perfusion images and increased activity on the delayed blood-pool images, whereas the remaining 3 (11%) showed normal activity on both perfusion and blood-pool images. Finally, 5 of 5 (100%) capillary or recemose hemangiomas showed increased activity on the perfusion and blood-pool images.

Perfusion and blood-pool scintigraphy demonstrated sufficiently high sensitivity but relatively low specificity for detecting head and neck hemangiomas. Additionally, perfusion and blood-pool scintigraphy can clearly differentiate between cavernous and venous hemangiomas and capillary and recemose hemangiomas and are extremely useful for the detection and evaluation of head and neck hemangiomas.