title: Pitfalls in the Performance and Interpretation of Scintigraphic Imaging for Pleuroperitoneal Shunt.
abstract: Ascites can cause pleural effusions when the peritoneal fluid crosses the diaphragm through a pleuroperitoneal shunt in the setting of hepatic cirrhosis (hepatic hydrothorax) or malignant ascites. Scintigraphic imaging for pleuroperitoneal shunt requires intraperitoneal injection of Tc-SC or Tc-macroaggregated albumin followed by planar imaging of the chest and abdomen. Pleuroperitoneal shunt is confirmed by identifying radiotracer crossing the diaphragm from the peritoneal to pleural space. An atlas of pleuroperitoneal shunt imaging pitfalls is presented to facilitate optimal performance and interpretation of nuclear pleuroperitoneal shunt examinations. Examples include cases of nondiagnostic radiotracer injections, processing errors, and nontarget uptake.
authors.affiliation: From the *Department of Medical Imaging, Banner University Medical Center Tucson; and Departments of †Medical Imaging, ‡Medicine, and §Biomedical Engineering, University of Arizona College of Medicine, Tucson, AZ.
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Covington
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Choudhary
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Avery
authors.forename: Phillip H
authors.initials: PH
authors.lastname: Kuo
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000368:Aged; D003951:Diagnostic Errors; D003964:Diaphragm / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin