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 e valuated their histopathologic types, Methods: Perfusion and blood-poo l scintigraphy with Tc-99m-red blood cells (RBCs) or Tc-99m-human seru m 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 conf irmed to be hemangiomas, whereas the remaining 18 were histologically diagnosed as other lesions. Results: Perfusion and blood-pool scintigr aphy correctly diagnosed 30 of 33 hemangiomas as being hemangiomas but could not detect the remaining 3 hemangiomas. Perfusion and blood-poo l scintigraphy correctly diagnosed 12 of 18 lesions as nonhemangiomas, but the remaining 6 lesions were misdiagnosed as hemangiomas. Thus, t he sensitivity for detecting hemangiomas was 91%, with a specificity a nd accuracy of 67% and 82%, respectively, Twenty-five (89%) of 28 cave rnous or venous hemangiomas demonstrated normal activity on the perfus ion images and increased activity on the delayed blood-pool images, wh ereas the remaining 3 (11%) showed normal activity on both perfusion a nd blood-pool images. Finally, 5 of 5 (100%) capillary or racemose hem angiomas showed increased activity on the perfusion and blood-pool ima ges. Conclusion: Perfusion and blood-pool scintigraphy demonstrated su fficiently high sensitivity but relatively low specificity for detecti ng head and neck hemangiomas. Additionally, perfusion and blood-pool s cintigraphy can clearly differentiate between cavernous and venous hem angiomas and capillary and racemose hemangiomas and are extremely usef ul for the detection and evaluation of head and neck hemangiomas.