title: Bilateral photon deficient area along lateral abdominal wall in a Tc-99m DTPA renogram. A sign of massive ascites.
abstract: A patient with congestive heart failure and hepatic and renal dysfunction underwent Tc-99m DTPA renal scintigraphic studies in which persistent cardiac blood pool activity, hepatic arterialization, and a longitudinal photon deficient area in each side of the abdominal wall were observed. The increase in hepatic artery inflow was believed to be due to a decrease in portal inflow of the liver. The elevation of portal pressure secondary to heart failure is attributable to the decrease in portal inflow of the liver; this phenomenon could account for the hepatic arterialization. Progressive renal dysfunction with high body background resulted in demonstrable ascites as photon deficient areas. Scintigraphic findings of hepatic arterialization plus an abdominal photon deficient area reflect severe heart failure and renal dysfunction.
authors.affiliation: Nuclear Medicine Service, Department of Veterans Affairs, Lexington, Kentucky.
authors.forename: W J
authors.initials: WJ
authors.lastname: Shih
authors.forename: L S
authors.initials: LS
authors.lastname: Marsano
mesh_terms: D000009:Abdominal Muscles / Q000000981:diagnostic imaging* / Q000473:pathology; D000368:Aged; D001201:Ascites / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011866:Radioisotope Renography; D016284:Technetium Tc 99m Pentetate
chemical_list: D016284:Technetium Tc 99m Pentetate