technetium-tc-99m-mebrofenin and Liver-Abscess

We studied a previously healthy patient who presented with a 3-wk history of fever, flu-like symptoms and abdominal pain.. Blood cultures were positive for Escherichia coli. A computed tomography (CT) scan revealed a 2-cm low-density focus in the right hepatic lobe. A technetium-99m-mebrofenin scan showed a photopenic area in the right hepatic lobe surrounded by a rim of activity greater than the adjacent parenchymal activity.. Gallbladder visualization was normal and the diagnosis of hepatic abscess was made. CT-guided percutaneous drainage of the lesion yielded six cc of pus, the culture of which grew E. coli, Prevotella and Bacteroides fragilis. Drainage and a 6-wk course of intravenous antibiotics were followed by clinical improvement and resolution of the abscess by CT.. The rim sign and its possible mechanism of causation in hepatic abscess are discussed in this report, together with a review of the literature.

Topics: Aniline Compounds; Bacteroidaceae Infections; Bacteroides fragilis; Bacteroides Infections; Escherichia coli Infections; Glycine; Humans; Imino Acids; Liver Abscess; Male; Middle Aged; Organotechnetium Compounds; Prevotella; Radionuclide Imaging; Radiopharmaceuticals; Tomography, X-Ray Computed

A young male suffering from fulminant hepatic failure of unknown origin had an auxiliary partial orthotopic liver transplantation performed. The aim of the present study was to test the performance of factor analysis of medical image sequences (FAMIS) in the post-transplantation monitoring of the graft and native liver functions.. Four successive hepatobiliary studies within 63 days following transplantation using 99mTc-mebrofenin were performed (on days 13,20,34,63). The 60 one-minute dynamic series were subjected to two successive FAMIS procedures.. For all studies, except the first, FAMIS was able to extract three factor couples (factor images and factors or curves) those of the native liver, the graft liver and the biliary region. The factors time evolution in uptake and excretion components showed the correlations between clinical status and scintigraphic results and helped interpretation of biochemical tests.. The possible utility of systematic liver transplant monitoring by radionuclide hepatobiliary imaging in identification of complications requiring medical or surgical intervention in graft livers was demonstrated. Furthermore, our study showed the functional recovery potential of the native liver in patients suffering from fulminant hepatitis.

Topics: Adolescent; Aniline Compounds; Factor Analysis, Statistical; Glycine; Graft Rejection; Hepatic Encephalopathy; Humans; Imino Acids; Liver; Liver Abscess; Liver Transplantation; Male; Organotechnetium Compounds; Postoperative Complications; Radionuclide Imaging; Reoperation; Time Factors