Anterior and posterior images are shown
View main image(ls) in a separate image viewer
View second image(ls). Transaxial SPECT images
View third image(ct). Contrast CT with liver windowing
Full history/Diagnosis is available below
Note that these are non-attenuation-corrected images, so there should be apparently decreased activity in deeper structures. The lesion is more intense that the immediately adjacent liver.
The Kupffer cells in focal nodular hyperplasia allow accumulation of sulphur colloid, which produces activity in the lesion which is equal to or greater than surrounding liver activity on liver-spleen scintigraphy. Most other liver lesions do not have Kupffer cells, and therefore show decreased activity. A subset of hepatic adenomas do accumulate sulphur colloid, and will also show activity on a liver-spleen scan. These lesions, however can usually be distinguished from focal nodular hyperplasia, because adenomas are prone to hemorrhage and necrosis, which appear as heterogeneous areas of decreased activity on the scan. SPECT imaging has been shown to increase the diagnostic accuracy in evaluating hepatic lesions.
Sandler MP et al: Diagnostic Nuclear Medicine. 3rd ed. Baltimore, Williams and Wilkins. 1996. p753
Zeman RK, Pauschter DM, Schiebler ML, et al. Hepatic Imaging:current status. Radiologic Clinics of N. Am. 23(3):473-87, 1985.
DeLand FH, Shis WJ: The status of SPECT in tumor diagnosis. JNM 25(12): 1375-9, 1984
References and General Discussion of Liver-Spleen Scintigraphy (Anatomic field:Gasterointestinal System, Category:Neoplasm, Neoplastic-like condition)
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