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Scintigraphic and Ultrasound Features of Giant Hemangiomas of the Liver

Departments of Nuclear Medicine and Diagnostic Radiology, Royal Victoria Hospital and McGill University, Montreal, Canada

Correspondence: For reprints contact: Robert Lisbona, MD, Dept. of Nuclear Medicine, Royal Victoria Hospital, 687 Pine Ave. West, Montreal, Quebec H3A 1A1 Canada.

ABSTRACT

Giant hemangiomas of the liver are clinically distinct from smaller and more innocent hemangiomas as they are more prone to complications. On imaging with ultrasound, they can also be readily confused with hepatoma, metastatic disease, or focal nodular hyperplasia. Nine giant hemangiomas (maximal diameter > 8 cm) were studied by scintigraphy and ultrasound. In all instances, the fill-in of the lesion on [^99mTc]RBC scintigraphy indicated the diagnosis of hemangioma, adding specificity to the screening sonographic study. The pattern of fill-in on scintigraphy also appeared to be size dependent with lesions < 11 cm in diameter equilibrating uniformly, while larger abnormalities intensified in centripetal fashion.