*LIVER IMAGING INTERPRETATION*


1.HEPATOMEGALY
-ABSCESS
-CIRRHOSIS
-CYST (E.G., CONGENITAL, TRAUMATIC, HYDATID)
-FATTY INFILTRATION
-HEPATITIS
-HEPATOMA
-METASTASIS
-OTHER PRIMARY NEOPLASM-BENIGN OR MALIGNANT
-RIEDEL'S LOBE

2.MASSIVE HEPATOMEGALY
-ABSCESS
-AMYLOIDOSIS
-BILIARY CIRRHOSIS
-CONGESTIVE HEART FAILURE
-FATTY INFILTRATION
-HEMOCHROMATOSIS
-LEUKEMIA
-LYMPHOMA
-METASTATIC DISEASE
-POLYCYSTIC LIVER DISEASE

3.SOLITARY DEFECT IN THE LIVER
-ABSCESS
-ANY OF FALSE-POSITIVE CAUSES
-CYST
-HEMANGIOMA
-HEPATOMA
-METASTASES

4.PROMINENT PORTA HEPATIS
-CIRRHOSIS
-DILATED BILE DUCTS
-FIBROSIS
-METASTASIS
-NORMAL VARIANT

5.MULTIPLE COLD DEFECTS
-ABSCESS
-ANY OF FALSE-POSITIVE CAUSES
-BILIARY OBSTRUCTION
-METASTASES
-POLYCYSTIC DISEASE
-PSEUDOTUMOR IN CIRRHOSIS

6.COLD DEFECT IN A PEDIATRIC PATIENT
-ABSCESS (E.G., CHRONIC GRANULOMATOUS DISEASE, NEUTROPENIA)
-BENIGN TUMOR (E.G., HEMANGIOMA, HEMANGIOENDOTHELIOMA)
-CAROLI'S DISEASE
-CHOLEDOCHAL CYST
-CIRRHOSIS (E.G., CYSTIC FIBROSIS)
-CYST (E.G., POLYCYSTIC DISEASE)
-HEPATOMA
-METASTASIS (E.G., NEUROBLASTOMA, WILMS', LYMPHOMA)
-POSTTRAUMATIC (E.G., HEMATOMA, FOLLOWING SURGERY OR RADIATION)
-PSEUDODEFECT
-SCLEROSING CHOLANGITIS

7.FALSE-POSITIVE DEFECT IN THE LIVER
-ANATOMIC VARIATION OF LIVER SIZE, SHAPE, AND POSITION
-BREAST SHADOW
-GALLBLADDER FOSSA
-PORTA HEPATIS
-RIB IMPRESSION
-RIEDEL'S LOBE
-THIN LEFT LOBE

8.FOCAL INCREASED LIVER ACTIVITY (HOT SPOT)
-BUDD-CHIARI SYNDROME
-CIRRHOSIS (REGENERATING NODULES)
-FOCAL NODULAR HYPERPLASIA

9.LACK OF LIVER UPTAKE OF SULFUR COLLOID
-ADVANCED CIRRHOSIS
-FAMILIAL ERYTHROPHAGOCYTIC LYMPHOHISTIOCYTOSIS
-INTESTINAL BYPASS
-IRRADIATION (USUALLY NOT COMPLETE)
-SCHISTOSOMA MANSONI INFESTATION
-SEVER HEPATITIS
-TUBERCULOSIS

10. SULFUR COLLOID UPTAKE IN THE KIDNEYS
-CONGESTIVE HEART FAILURE
-RENAL TRANSPLANT-REJECTION

11.SULFUR COLLOID UPTAKE BY THE LUNGS
-CHILDHOOD (FAINT UPTAKE IS NORMAL)
-CIRRHOSIS
-HYPERCOAGULABLE STATE
-MALIGNANCY (E.G., METASTASES, MALIGNANT LYMPHOMA)
-RADIOPHARMACEUTICAL PREPARATION

12. DISPARATE IMAGING WITH SULFUR COLLOID AND IDA: DECREASED ACTIVITY WITH S.C. AND NORMAL OR INCREASED ACTIVITY IN IMINODIACETIC ACID (IDA) IMAGE
-CIRRHOSIS
-DILATED GALLBLADDER
-DILATED HEPATIC DUCT
-FOCAL NODULAR HYPERPLASIA
-HEPATIC ADENOMA
-HEPATOMA
-INTRAHEPATIC GALLBLADDER

13.INHOMOGENEOUS UPTAKE
-CIRCULATORY
CONGESTIVE HEART FAILURE (ACUTE MYOCARDIAL INFARCTION, CARDIOMYOPATHY, VALVULAR DISEASE)
CONSTRUCTIVE PERICARDITIS
EXTRINSIC COMPRESSION
HEPATIC ARTERY OBSTRUCTION
HIGH OUTPUT STATES (E.G., THYROTOXICOSIS,PAGET'S DISEASE, BERIBERI)
HYPOVOLEMIA
INCREASED RED CELL DESTRUCTION (E.G., SPHEROCYTOSIS, THALASSEMIA MAJOR)
INFERIOR VENA CAVA AND HEPATIC VEIN OBSTRUCTION
PORTAL OR SPLENIC VEIN OBSTRUCTION (E.G.,CIRRHOSIS, SS DISEASE,ETC.)
PULMONARY EMBOLISM
PULMONARY HYPERTENSION

-INFILTRATIVE
ACTINOMYCOSIS
ALCOHOLIC HEPATITIS
ALPHA-1-ANTITRYPSIN DEFICIENCY
AMYLOIDOSIS
BRUCELLOSIS
CELIAC DISEASE
CHRONIC ACTIVE HEPATITIS
CHRONIC VITAMIN A INTOXICATION
DRUGS (E.G., PHENOTHIAZINES, INH, ADRIAMYCIN, PHENOBARBITAL, TESTOSTERONE, ESTROGENS, OXACILLIN, TETRACYCLINE, WARFARIN)
DUBIN-JOHNSON SYNDROME
EXTRAMEDULLARY HEMATOPOIESIS (E.G., MYELOFIBROSIS WITH: MYELOID METAPLASIA)
FATTY INFILTRATION (E.G., DIABETES, MALABSORPTION SYNDROMES, HYPERALIMENTATION)
GAUCHER'S DISEASE
HEMOCHROMATOSIS
HISTOPLASMOSIS
HYPEREOSINOPHILIC SYNDROMES
HYPERGAMMAGLOBULINEMIA
IDIOPATHIC CIRRHOSIS
INFECTIOUS MONONUCLEOSIS
LEAD POISONING
LESCHMANIASIS
LEUKEMIA (E.G., CHRONIC MYELOCYTIC,LYMPHOCYTIC, HAIRY CELL)
LIVER TRANSPLANT
LYMPHOMA, LYMPHOSCAROMA, HODGKIN'S DISEASE
MALARIA
METASTASIS
NIEMANN-PICK DISEASE
POLYARTERITIS NODOSA
POLYCYSTIC LIVER DISEASE
POLYCYTHEMIA VERA
PRIMARY BILIARY CIRRHOSIS
SARCOIDOSIS
SCHISTOSOMIASIS
SYPHILIS
THROMBOCYTHEMIA
ULCERATIVE COLITIS
VIRAL HEPATITIS
WALDENSTROM'S MACROGLOBULINEMIA
WILSON'S DISEASE

14. DISPARATE IMAGING WITH SULFUR COLLOID AND IDA: NORMAL ACTIVITY WITH S.C. AND DECREASED ACTIVITY IN IDA IMAGE
-HEPATITIS

15. WIDENED RENAL FOSSA
-HEPATIC ABSCESS
-HEPATIC TUMOR (PRIMARY OR SECONDARY)
-HYDRONEPHROSIS
-HYPERNEPHROMA
-POLYCYSTIC RENAL DISEASE
-PERINEPHRIC ABSCESS
-RETROPERITONEAL HEMATOMA

16.EARLY OR INCREASED FLOW TO THE LIVER
-CHRONIC LIVER DISEASE
-HEPATOMA
-LYMPHOMA
-METASTATIC DISEASE

17.FOCALLY DECREASED FLOW (SOLITARY OR MULTIPLE)
-ABSCESS (AMEBIC OR PYOGENIC)
-CYST (ANY ETIOLOGY)
-EXTRINSIC MASS
-HEMANGIOMA
-HEMATOMA
-HEPATOMA
SOME METASTASES

18.LIVER-LUNG SCAN
SEPARATION BETWEEN LIVER AND LUNG ACTIVITY
-RIGHT LOWER LOBE PNEUMONIA, ATELECTASIS, OR PLEURAL EFFUSION
-SUBPHRENIC ABSCESS



*LIVER & SPLEEN CLINICAL APPLICATIONS*
* LIVER-USEFUL TIPS *
*HEPATOBILIARY IMAGING INTERPRETATION*
*SPLEEN IMAGING INTERPRETATION*
* LIVER & SPLEEN *