Observation on porta hepatis scintiscan defects

Kim, G E; Cho, O K; Park, C Y

Abstract

On the evaluation of liver scintiscan, the author has not infrequently met misinterpretations of fillingdefects in the region of the porta hepatis. A total 167 cases of the liver scintiscan, which showed defect at thisarea, in this hospital from Jan. 1975 to Apr. 1977 were reviewed retrospectively. On the basis of pathologicand/or surgical correlation, 37 cases of them were analyzed. Because of the wide normal variation in thescintigraphic appearance of the porta hepatis, superimposed or inherent anatomical structures such as intrahepaticgall bladder, hepatic vein, and others, the identification of extrainsic and intrinsic edge lesions in this areais a difficult diagnostic pitfalls. The space occupying lesion within the liver and the parenchymal liver diseasesas well as extrahepatic pathologic lesion bringing about the dilataion of the intrahepatic ducts, have alreadybeen indicated as causes of the filling defects at the hepatic hilum by many authors. Numerous authors haverecommended caution in interpretating the marginal irregularities and a solitary focal defect, especially if theseare seen on only one projection. Non-specificity and limitation of the resolution of scintiscan have also beenanother interfering factors of accurate evaluation. For this reasons, objective findings have been required inorder to evalute these defects more exactly. The authors has studied in terms of the various causative disease andmorphologic patterns of these defects with above proven cases.