Scintigraphic right-to-left liver lobe ratio and liver-to-spleen ratio in cirrhosis and non cirrhotic liver diseases.
Various criteria are used together for the scintigraphic diagnosis of cirrhosis as no single criterion may be reliable. However, low right-to-left hepatic lobe uptake ratio has been reported to be sensitive and specific for alcoholic cirrhosis. A low liver-to-spleen uptake ratio has also been reported in various hepatocellular disorders. We tested these ratios in patients with cirrhosis and non cirrhotic causes of portal hypertension. The right-to-left lobe uptake ratio was significantly lower (1.59 +/- 1.23 vs 2.36 +/- 0.63 in normals; p = 0.037) in only Child's C alcoholic cirrhosis, but the sensitivity of this ratio was low (40%) even in this subgroup of cirrhosis (mean +/- SD 1.72 +/- 1.08) as against 1 of 10 patients with non cirrhotic portal hypertension (3.57 +/- 1.33; p = 0.0005). We conclude that the right-to-left hepatic lobe uptake ratio is not a discriminatory scintigraphic sign in liver disease. A low liver-to-spleen uptake ratio can distinguish cirrhosis from non cirrhotic causes of portal hypertension.
Khanna
M U
MU
Department of Gastroenterology, KEM Hospital, Bombay.
Abraham
P
P
Shikare
S S
SS
Tilve
G H
GH
D003937:Diagnosis, Differential; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging*; D008099:Liver / Q000000981:diagnostic imaging*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008104:Liver Cirrhosis, Alcoholic / Q000000981:diagnostic imaging*; D015609:Organotechnetium Compounds; D010833:Phytic Acid; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging*; D013671:Technetium Tc 99m Sulfur Colloid
D015609:Organotechnetium Compounds; C026177:technetium phytate; D013671:Technetium Tc 99m Sulfur Colloid; D010833:Phytic Acid