title: Use of 99mTCO4(-) trans-splenic portal scintigraphy for diagnosis of portosystemic shunts in 28 dogs.
abstract: Ultrasound-guided percutaneous trans-splenic portal scintigraphy (TSPS) using 99mTcO4(-) has been used to image the portal venous system in normal dogs. Compared with per-rectal portal scintigraphy, it provides higher count density, consistent nuclear venograms of the splenic and portal vein, and significantly decreased radiation exposures. This paper describes the use of TSPS for the diagnosis of portosystemic shunts in 28 dogs. TSPS was performed injecting 70 +/- 28 MBq of 99mTcO4(-) (mean +/- SD) into the splenic parenchyma with ultrasound guidance. A dynamic acquisition at a frame rate of four frames/s for 5 min was initiated after placement of the needle and approximately 2s prior to injection. All dogs had diagnoses confirmed via exploratory laparotomy or ultrasonographic identification of the shunting vessel(s). Three studies (10.7%) were nondiagnostic because of intraperitoneal rather than intrasplenic injection of the radionuclide. Three pathways were recognized on the scintigraphic images: (1) portoazygos shunts--the 99mTcO4(-) bolus traveled dorsally, running parallel to the spine and entering the heart craniodorsally; (2) single portocaval or splenocaval shunts--the 99mTcO4(-) bolus ran from the area of the portal vein/splenic vein junction in a linear fashion toward the caudal vena cava entering the heart caudally; (3) internal thoracic shunt-the 99mTcO4 bolus traveled ventrally along the thorax and abdomen entering the cranial aspect of the heart. Single and multiple shunts were easily distinguished. There were no distinguishing features between single intra and extrahepatic portocaval shunts.
authors.affiliation: Department of Small Animal Clinical Sciences , Veterinary Teaching Hospital, University of Tennessee, Knoxville, TN 37996-4544, USA. fmorandi@utk.edu
authors.forename: Federica
authors.initials: F
authors.lastname: Morandi
authors.forename: Robert C
authors.initials: RC
authors.lastname: Cole
authors.forename: Karen M
authors.initials: KM
authors.lastname: Tobias
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Berry
authors.forename: James
authors.initials: J
authors.lastname: Avenell
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Daniel
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000000981:diagnostic imaging*; D004285:Dogs; D005260:Female; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000662:veterinary*; D008297:Male; D011168:Portal System / Q000002:abnormalities* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging / Q000662:veterinary; D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m; D013154:Spleen / Q000000981:diagnostic imaging; D018084:Ultrasonography, Interventional / Q000662:veterinary
chemical_list: D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m