title: A rare portosystemic shunt detected by MRI and diagnosed by dynamic liver scintigraphy with Tc-99m phytate.
abstract: Although various types of portosystemic shunts with portal hypertension have been widely reported, a collateral circulation near the pancreas head is rare. The authors report a case of a rare portosystemic shunt surrounding the pancreatic head, which was diagnosed by dynamic liver scintigraphy using Ikoma's scintigraphic criteria for the presence of portosystemic shunts. According to these criteria, abnormal accumulation of radioactivity at various abdominal sites (not identified on static images after the dynamic study) on 6 or more continuous frames of 5-second intervals (i.e., for 30 seconds or more after the arterial phase) indicates the presence of a portosystemic shunt. If liver scintigraphy is performed on a patient with portal hypertension, the dynamic study is valuable in the detection and diagnosis of a portosystemic shunt.
authors.affiliation: Department of Radiology, St. Marianna University Tohyoko Hospital, Kawasaki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Imanishi
authors.forename: M
authors.initials: M
authors.lastname: Hayakawa
authors.forename: T
authors.initials: T
authors.lastname: Itoh
authors.forename: H
authors.initials: H
authors.lastname: Mitsuhashi
authors.forename: M
authors.initials: M
authors.lastname: Masuoka
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
authors.forename: K
authors.initials: K
authors.lastname: Mizutani
authors.forename: O
authors.initials: O
authors.lastname: Kawazoe
authors.forename: M
authors.initials: M
authors.lastname: Fujikawa
authors.forename: S
authors.initials: S
authors.lastname: Momose
mesh_terms: D000368:Aged; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008099:Liver / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008642:Mesenteric Veins; D015609:Organotechnetium Compounds; D010179:Pancreas / Q000098:blood supply; D010833:Phytic Acid; D011168:Portal System / Q000503:physiopathology*; D011877:Radionuclide Imaging; D014682:Vena Cava, Inferior
chemical_list: D015609:Organotechnetium Compounds; C026177:technetium phytate; D010833:Phytic Acid