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Nuc Med > Hepatic Hemangioma > Flashcards

Hepatic Hemangioma Flashcards

1
Q

RP

Dose

TTI

A
  • 20-30 mCi Tc tagged RBC
  • Image Immediately - Flow possible
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2
Q

Indications

A
  • Detect and localize mass on CT
  • Typically an incidental finding
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3
Q

Contraindications

A
  • Contrast Studies
  • Blood transfusions
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4
Q

Patient Prep

A
  • 18 gauge needle
  • Heparinized syringe
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5
Q

Positioning

A
  • Supine with liver, spleen in center FOV
  • Use point source to ensure proper positioning
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6
Q

Target Organ

Critical Organ

Route of Excretion

Method of Localization

A
  • Target: Blood (Hemangioma)
  • Critical: Liver
  • Excretion: Bowel
  • Localization: Compartmentalization
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7
Q

Procedure

A
  • Draw and tag blood - wait 20 min to incubate
  • Flow: 1 s/f for 60 sec. To determine non-vascularized lesion or hemangioma
  • Statics: Every 15 min for 60 min. 500k-1M counts. ANT w/ marker, ANT/POS, LAT, OBL - where on CT.
  • Dynamic: 60 s/f for 60 min
  • SPECT: 1-2 hours after injection. Only hemangioma will be hot.
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8
Q

Acquisition

A
  • LEAP or LEHR
  • Computer Set Up: Liver Hemangioma
  • 64x64 for Flow
  • 256x256 or 512x512 for Staics
  • 128x128 for Dynamic and SPECT
  • SPECT: 360º elliptical. 20-30 sec/ stop for 64 stops. 1.4-1.5x zoom
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9
Q

Processing

A
  • JS: Hemangioma SPECT. Generic Viewer - AB
  • Peg: Hemangioma. All Dyn. - AB
  • POS-LPO-LLAT-LAO-ANT-RAO-RLAT-RPO
  • gamma.wustl.edu: Hepatic blood pool scintigraphy. 2nd cavernous hemangioma. good tag - AB
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10
Q

Normal

Abnormal

A
  • Norm: Blood filled spaces: heart, great vessels, liver, spleen.
  • Norm: kidneys - maybe
  • Norm: homogenous uptake of liver
  • AB: hypervascular area in/around liver/abdomen
  • AB: increased activity over time - only hemangioma
  • AB: Cold - space occupying mas (tumor/cyst)
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11
Q

Treatment

A
  • Most hemangiomas will dissipate on their own
  • Only treated when causing significant pain
  • Surgery or close medical management
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12
Q

Labels

A
  • Name
  • DOB
  • MRN
  • Date of Exam
  • Hospital
  • Referring physician
  • Dose
  • Dose rate
  • Frame rate
  • Left/ Right
  • View ID
  • Tech Initials
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Nuc Med (22 decks)

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