technetium-tc-99m-sulfur-colloid and Hepatitis--Chronic

Topics: Hepatitis B; Hepatitis B Surface Antigens; Hepatitis, Chronic; Humans; Liver Cirrhosis, Alcoholic; Liver Diseases; Radionuclide Imaging; Splenomegaly; Technetium Tc 99m Sulfur Colloid

The purpose of the study was to determine whether a correlation between the radioisotopic "spleen-to-liver" ratio and the hepatic damage (according to Knodell's Index) exists in patients with chronic liver disease, in order to ascertain whether hepatic biopsy should be performed under visual (laparoscopic) control or not (blind liver biopsy). Thirty patients with inflammatory chronic hepatic disease were studied (9 chronic persistent hepatitis, 14 active chronic hepatitis and 7 hepatic cirrhosis). An inverse correlation was found between Knodell's Index and the "spleen-to-liver" ratio with moderate statistical significance (r = -0.46). In conclusion, the isotopic "spleen-to-liver" ratio correlates moderately well with the degree of hepatic damage and consequently it can only be used as orientation about the preferable way for obtaining a liver biopsy (laparoscopically or not).

Topics: Biopsy; Chronic Disease; Hepatitis, Chronic; Humans; Liver; Liver Diseases; Radionuclide Imaging; Spleen; Technetium Tc 99m Sulfur Colloid; Ultrasonography

Two cases of right hepatic hydrothorax occurring in the absence of clinical ascites are reported. Diagnosis was confirmed by the intraperitoneal and intrapleural injection of radioisotope 99mTc-sulfur colloid that demonstrated the one-way transdiaphragmatic flow of fluid from the peritoneal to pleural cavities. In contrast, radioisotope injected into the peritoneal cavity of 5 patients with pleural effusions secondary to pulmonary or cardiac disease failed to traverse the diaphragm and localize in the pleural space. Medical therapy with salt and water restriction and diuretics resulted in both of the patients with hepatic hydrothorax developing signs of intravascular volume depletion without significant mobilization of the pleural fluid. Thoracotomy allowed identification of the diaphragmatic defects that were repaired by chemical and traumatic pleurodesis followed by postoperative peritoneal and pleural drainage. This therapy resulted in complete resolution of the pleural effusions, which have not recurred despite the subsequent development of clinical ascites in both patients.

Topics: Ascitic Fluid; Female; Hepatitis, Alcoholic; Hepatitis, Chronic; Humans; Hydrothorax; Liver Cirrhosis, Alcoholic; Middle Aged; Pleural Effusion; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid