Single photon emission computed tomograms of the liver: normal vascular intrahepatic structures.

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Abstract
Because of the high target-to-background contrast obtained with single photon emission computed tomography (SPECT), normal intrahepatic vessels .apprx. 2 cm in diameter may appear as distinct focal defects in tomographic sections throughout the liver even though normal vessels rarely cause such defects on planar images. To assess this problem, 5 [human] subjects without evidence of liver disease underwent tomography of the liver with 99mTc sulfur colloid (TSC) and on a separate occasion tomography of the intrahepatic blood pool with 99mTc autologous red blood cells (RBC). In each case, well demarcated defects were obvious in continguous TSC liver tomograms in various planes. Direct comparison with RBC tomograms showed that all of these defects corresponded to intrahepatic veins, typically the right portal vein, its posterior branch and the left portal vein. Knowledge of the intrahepatic vascular anatomy in a variety of tomographic planes, with examination of each defect in multiple orthogonal planes is necessary to avoid false positive interpretations. In some instances a study with RBC may also be required for more conclusion evaluation of defects seen on TSC liver tomograms.