CHARACTERIZATION OF CONGENITAL VASCULAR MALFORMATION IN THE EXTREMITIES USING WHOLE BODY BLOOD POOL SCINTIGRAPHY AND LYMPHSCINTIGRAPHY

Abstract

The purpose of this study was to investigatethe clinical usefulness of combined wholebody blood pool scintigraphy (WBBPS) andlymphscintigraphy (LS) in the characterizationof patients with congenital vascularmalformations (CVMs) of the extremities.Subjects included 134 patients who underwentTc-99m RBC WBBPS and Tc-99m filtered tincolloid (or antimony sulfur colloid) LS oninitial diagnosis. Scintigraphic results wereinterpreted as arteriovenous malformations(AVMs), venolymphatic malformations(VLMs), lymphatic malformations (LMs), andvenous malformations (VMs). Final diagnosisof the type of vascular malformation wasdetermined by physical examination, magneticresonance imaging (MRI), angiography,duplex ultrasonography, and/or biopsy results.The final diagnosis demonstrated that 14 ofthe study subjects had an AVM, 29 had aHLM, 20 had a LM, and 71 had a VM. Thesensitivity of WBBPS and LS in the characterizationof CVM was 85.7% (12/14) forAVMs, 96.6% (28/29) for VLMs, 95.0%(19/20) for LMs, and 88.7% (63/71) for VMs.The specificity was 100% for AVMs (120/120),91.4% for VLMs (96/105), 99.1% for LMs(113/114), and 98.4% for VMs (62/63). Theoverall accuracy of WBBPS and LS was91.0% (122/134). Our results show that combinationof WBBPS with LS can characterizeextremity CVMs in patients with highdiagnostic accuracy, and may thus be usefulfor making optimal treatment decisions.