technetium-tc-99m-lidofenin and Bile-Duct-Neoplasms

Discordant hepatic uptake between Tc-99m HIDA and Tc-99m colloid occurred in a 63-year-old female with segmental biliary obstruction due to cholangioma. Radiographic CT and a percutaneous transhepatic cholangiogram revealed the obstructed right hepatic duct as well as the dilated intrahepatic duct in the right lobe. At surgery this was confirmed, and a 2 cm mass encasing the right hepatic duct was identified. It should be included in the gamut of discordant hepatic uptake of Tc-99m IDA and Tc-99m colloid.

Topics: Adenoma, Bile Duct; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Biliary Tract Diseases; Constriction, Pathologic; Female; Humans; Imino Acids; Liver; Middle Aged; Organometallic Compounds; Radionuclide Imaging; Technetium; Technetium Compounds; Technetium Tc 99m Lidofenin; Tin; Tin Compounds

A case of bronchobiliary fistula diagnosed by 99mTc-HIDA cholescintigraphy is presented. The fistula caused by a stenosing tumor of the left hepatic duct would probably have been missed without the use of delayed views and body fluids counting which increased the specificity of scintigraphic findings.

Topics: Bile Duct Neoplasms; Biliary Fistula; Bronchial Fistula; Cholecystectomy; Cholestasis, Extrahepatic; Diagnosis, Differential; Female; Hepatic Duct, Common; Humans; Imino Acids; Mastectomy; Middle Aged; Postoperative Complications; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Segmental biliary obstruction as a result of primary or secondary hepatic malignancy has been reported with increasing frequency. For two representative patients, the clinical and Tc-99m HIDA scintigraphic findings in segmental biliary obstruction are described. The presence of photon-deficient dilated bile ducts in one segment of the biliary tree is highly suggestive of localized biliary obstruction and should be considered in the patient with suspected or proven hepatic malignancy despite the absence of jaundice.

Topics: Adenocarcinoma; Bile Duct Neoplasms; Cholestasis, Intrahepatic; Female; Humans; Imino Acids; Liver Diseases; Liver Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin