Clinical History

This is a 44-year-old female with known lesions in the left and right lober of her liver by CT, Ultrasound, and MRI. This examination is requested to corrolate with the Sulfur Colloid SPECT exam so the known lesions can be identified as tumor vs. cavernous hemangioma.

Technique

Utilizing 31 millicuries of 99m Tc04, the patient's red blood cells were tagged and multiple SPECT images of the abdomen were obtained. Transverse, sagittal, coronal and 3D volume rendered images were generated. Comparison is made from an outside previous RBC liver scan and 99m Tc-Sulfur Colloid scan.

Findings

Today's study demonstrates a cold mass lesion in the right lobe of the liver, which demonstrates increased uptake of the labeled RBC's primarily along the periphery of this lesion. This is similar in appearance to the patient's previous outside RBC exam. An additional focal area of increased uptake of the labeled red blood cells is seen in the left side of the abdomen, most likely in the left lobe of the liver, medial to the spleen. Both the cold and hot lesions correspond to the lesions seen on the Sulfur Colloid Liver SPECT exam.

Impressions

Mass lesions are identified in both the right and left lobes of the liver. The lesion in the right lober of the liver is cold on both the Sulfur Colloid SPECT exam and the RBC SPECT exam and appears to be a tumor. The lesion in the left lobe of the liver is cold on the Sulfur Colloid SPECT exam but is hot on the RBC SPECT exam. This lesion appears to be a cavernous hemangioma. There are also numerous lesions seen around the large mess in the right lobe of the liver which appear to be cavernous hemangioma's.

Comments

Click here if you would like to view a cine of the 3D volume rendered Red Blood Cell SPECT scan. This is a quicktime movie file.

Click here to review the Sulfur Colloid SPECT scan on this same patient.