Detection of hepatic shunts by the use of 131-I-macroaggregated albumin.

Abstract

Summary By scintiscanning the lung and liver following the injection of 131 I-macroaggre-gated albumin ( 131 I-MAA) into the spleen, the presence and degree of extra- and intrahepatic shunts were studied. On this basis, 13 patients among 15 cirrhotics and 1 patient with liver fibrosis had collateral circulation in the splenoportal system. Three patients with hemolytic anemias, 4 with hepatitis, and 2 with cirrhosis had no shunts. Shunt indices calculated from liver and lung counts in scintigrams ranged from 18 to 90 in patients with cirrhosis of the liver with shunts and below 6 in patients without shunts.The radioactivity accumulation curves were recorded over the liver and lung following MAA injection to detect the presence of intrahepatic shunts. An initial hump of the liver MAA accumulation curve was observed in 7 cirrhotics, suggesting the presence of intrahepatic shunts.The MAA transit time from spleen to liver was almost the same whether or not cirrhosis was present. Spleen to lung time through collateral veins ranged widely.The application of 131 I-MAA was considered to be an easy and useful method for the detection and semiquantitation of intra- and extrahepatic shunts in cirrhosis of the liver.