technetium-tc-99m-sulfur-colloid and Budd-Chiari-Syndrome

Topics: Angiography; Budd-Chiari Syndrome; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Ultrasonography, computed tomography and 99mTc liver scanning are all useful in diagnosis of patients with the Budd-Chiari syndrome. In a study to determine their comparative value characteristic findings were recorded in all nine patients at ultrasonography and in seven patients at computed tomography. In contrast 99mTc liver scan showed a characteristic pattern in only one of eight patients. In our experience intrahepatic venous abnormalities were seen better at ultrasonography than at computed tomography. In addition, abnormality in the direction of blood flow could be detected by pulsed Doppler examination. Ultrasonography is relatively inexpensive, readily accessible, does not require administration of radiation or contrast agents and therefore should be the primary non-invasive investigation of patients with Budd-Chiari syndrome, or those at risk of developing it.

Topics: Adult; Budd-Chiari Syndrome; Female; Humans; Liver; Male; Methods; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography

Budd-Chiari syndrome, a well known entity, is often difficult to diagnose, mostly due to the nonspecificity of its symptomatology. Radiocolloid liver scans were evaluated in eight cases of this disease, proven by surgical biopsy. Five cases showed the "classic" scintigraphic pattern of caudate lobe hypertrophy (62.5%), and other abnormalities observed included segmental hepatic insufficiency, diffuse hepatic insufficiency, and relative hypertrophy of both the caudate lobe and a portion of the parenchyma of segment VI (one case each). An experimental study of hepatic venous drainage performed on livers at autopsy revealed four groups of accessory hepatic veins in addition to the main hepatic veins. The occlusion of various parts of this drainage appears to relate to the various scintigraphic patterns that were encountered in patients with Budd-Chiari syndrome. A review of the literature revealed three additional patterns previously reported in association with Budd-Chiari syndrome (normal scan, diffuse hepatomegaly, and multiple filling defects). If all these variations are appreciated, liver scanning can be a valuable screening tool for Budd-Chiari syndrome and may also serve as a noninvasive means of follow-up.

Topics: Budd-Chiari Syndrome; Humans; Liver; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

A case of hepatocellular carcinoma (HCC) complicated by the Budd-Chiari syndrome is described. The antemortem diagnosis of both conditions was made with the unique findings of multitracer scintigraphy. The difficulty of diagnosing these two conditions by the conventional approach is reviewed. The advantages of using multitracer scintigraphy for evaluation of hepatic lesions are also discussed.

Topics: Budd-Chiari Syndrome; Carcinoma, Hepatocellular; Humans; Liver Circulation; Liver Neoplasms; Male; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography

Ultrasound scanning and 99mTc sulphur colloid scintigraphy are widely used in the diagnosis of the Budd-Chiari syndrome and have been compared at the time of presentation in 18 patients in whom the diagnosis was subsequently confirmed by histology and hepatic venography. Ultrasound was diagnostic in 16 (87%). The findings seen most often included hepatic vein abnormalities, caudate lobe hypertrophy with decreased reflectivity and compression of the inferior vena cava. Additional information not shown by scintigraphy included intracaval tumour, or thrombosis, and concomitant portal vein thrombosis. Although scintigraphic abnormalities were present in all patients, only in three (17%) was the 'classical' appearance of increased uptake and/or enlargement of the caudate lobe present. In one patient with nonspecific abnormalities on ultrasound, scintigraphy gave a positive diagnosis and it is in such cases that scintigraphy should continue to be used.

Topics: Adolescent; Adult; Budd-Chiari Syndrome; Humans; Middle Aged; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Ultrasonography

Topics: Adult; Budd-Chiari Syndrome; Female; Humans; Liver; Liver Regeneration; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

A case of Budd-Chiari syndrome is presented in which computed tomography (CT) and ultrasonography suggested the correct diagnosis and excluded adjacent tumor as the cause of hepatic vein occlusion. The CT appearance in this case (homogeneously increased attenuation of an enlarged caudate lobe) differed from the appearance previously reported (patchy liver enhancement) in Budd-Chiari syndrome. Underlying mechanisms responsible for the different CT appearance are discussed.

Topics: Budd-Chiari Syndrome; Female; Hepatic Veins; Humans; Liver; Middle Aged; Phlebography; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography; Vena Cava, Inferior

Budd-Chiari syndrome or hepatic vein occlusion may be related to oral contraceptive medication. A patient is presented in whom radionuclide liver imaging contributed to the diagnosis of the syndrome and to the management of the patient.

Topics: Adult; Budd-Chiari Syndrome; Contraceptives, Oral; Female; Humans; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid