To determine whether the liver-scan findings previously shown to be related to portal-systemic collateral circulation occur only in patients with fibrotic liver disease, 567 hepatic scans with gold Au 198 performed over a six-year period were reviewed. Observance for liver "mottling," splenic uptake, or bone-marrow uptake of the isotope showed that one or more of these abnormalities was present in 51 (9.0%) of the patients. Evidence of portal-systemic collateral circulation on scan was most prominent in hepatic cirrhosis (76.6%); extrahepatic malignancies, acute and chronic hepatitis, hereditary hemorrhagic telangiectasia, and chronic lung disease accounted for the remainder. Evidence of portal-systemic shunting is most common in cirrhosis, and, when seen in the noncirrhotic patient, occurs when portal hypertension and hepatic collateral circulation are likely to be present.
Johnson RB, Castell DO, Lukash WM. Liver Scanning for Detection of Collateral Circulation in Liver DiseaseA Survey of 567 Hepatic Photoscans. JAMA. 1969;207(3):528-532. doi:10.1001/jama.1969.03150160040009