technetium-tc-99m-lidofenin and Dilatation--Pathologic

Topics: Adolescent; Bile Duct Diseases; Bile Ducts, Intrahepatic; Dilatation, Pathologic; Female; Humans; Imino Acids; Liver Abscess; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Caroli's disease (congenital dilatation of the intrahepatic bile ducts) is a rare condition which is usually diagnosed postoperatively. Scintigraphic evaluation of this entity is very limited. We report here a patient with Caroli's disease in whom a dichotomy in hepatic uptake of 99mTc-HIDA (hot spots) and 99mTc-colloid (cold spots) was observed, leading to a correct preoperative evaluation of the disease.

Topics: Adult; Bile Ducts, Intrahepatic; Biliary Tract; Cysts; Dilatation, Pathologic; Female; Humans; Imino Acids; Liver; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Lidofenin; Technetium Tc 99m Sulfur Colloid

Three cases of choledochal cyst associated with intrahepatic biliary dilatation are presented. Findings on sonography included a large cystic mass in the porta hepatis separate from the gallbladder; a dilated common hepatic or common bile duct entering directly into the cyst; the smaller cystic masses of dilated central intrahepatic ducts. The dilatation of the central intrahepatic bile ducts was moderate in two patients and massive in one patient. All three patients underwent operation with intraoperative cholangiography. Two patients had 99mTc IDA cholescintigraphy which confirmed the diagnosis of choledochal cyst by demonstrating filling of the cyst with stasis and delayed intestinal activity. The accurate preoperative diagnosis of choledochal cyst, made by sonography combined with 99mTc IDA cholescintigraphy, obviated invasive studies.

Topics: Bile Duct Diseases; Bile Ducts, Intrahepatic; Child; Child, Preschool; Common Bile Duct Diseases; Cysts; Dilatation, Pathologic; Female; Humans; Imino Acids; Male; Organotechnetium Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Ultrasonography