두경부 혈관종 진단시 99mTc-RBC Scan and SPECT 검사의 유용성

Usefulness of 99mTc-labeled RBC Scan and SPECT in the Diagnosis of Head and Neck Hemangiomas

Purpose: There are various methods to diagnose hemangioma, such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine. However, by development of SPECT imaging, the blood-pool scan using ⁹⁹ᵐTc-labeled red blood cell has been used, because it was non-invasive and the most economical method. Therefore, in this study, we proposed that the usefulness of ⁹⁹ᵐTc-RBC scan and SPECT of the head and neck to diagnose unlocated hemangiomas. Materials and Methods: ⁹⁹ᵐTc-RBC scan and SPECT was performed on 6 patients with doubtful hemangioma (4 person, head; 1 person, neck; 1 person, another). We labeled radiopharmaceutical using modified in vivo method and then, centrifuged it to remove plasma. After a bolus injection of tracer, dynamic perfusion flow images were acquired. Then, anterior, posterior, both lateral static blood-pool images were obtained as early and 4 hours delayed. SPECT was progressed 64 projections per 30 seconds. Each image was interpreted by physicians, Nuclear medicine specialist, and technologist blinded to patient’s data. Results: In 5 patients of all the radioactivity of doubtful site didn’t change in flow images, but, in blood-pool, delayed and SPECT images, it was increased. So, it was a typical hemangioma finding. The size of lesion was over 2 cm, and it could discriminate as comparing to the delayed and SPECT imaging. On the other hand, in 1 patient, the radioactivity was increased in blood-pool images, but, not in delayed and SPECT images, so, it was proved no hemangioma. Conclusion: Using ⁹⁹ᵐTc-RBC Scan and SPECT, we could diagnose the hemangiomas in head and neck, as well as, liver, more non-invasive, economical, and easy. Therefore, it considered that ⁹⁹ᵐTc-RBC scan and SPECT would offer more useful information for diagnosis of hemangioma, rather than otherimaging such as US, CT, MRI.