Cavernous Hemangioma

1. This type of liver disease was mentioned previously in your liver/spleen lecture and now requires a more in-depth look
2. Anatomy and physiology
1. Found in the liver usually in the right lobe
2. Lesion contain large blood volume, endothelial-lined spaces, and may be more diffused than be capsulated
3. Occurs in 3 to 7% of the population and has a greater affinity in women (4:1)
4. Usually benign and singular, however, can appear multiple
5. Is usually located in the right lobe of the liver
6. Usually the patient is symptomatic, however, if the tumor gets too large it can displace the surround structure and the patient may have interment pain
7. Usually found accidentally in a CT scan – nuclear medicine is used to determine the nature of the lesion
3. Procedure
1. Inject 20 to 30 mCi of technetium labeled RBCs
2. Dynamic and immediate static images will show an area within the liver void of uptake
3. Two to three hour delayed images will show increased activity within the cold area seen in the initial images
4. SPECT imaging is suggested
1. LEHR collimator
2. 360 degree
3. 128 x 128 matrix
4. 120 stops at 30 seconds per stop
4. Case Review

The following SPECT images show an area of increased uptake in the right lobe of the liver. This is seen in all three views: transverse, sagittal, and coronal. If a Tc99mSulfur Colloid study was done in the same venue a lack of uptake would be noted in the same projections.

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