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Unusual Appearance of Viable Liver on Tc-99m Mebrofenin Hepatobiliary Imaging

AL-NAHHAS, ADIL M., M.Sc., M.R.C.P.*; KINGSNORTH, ANDREW, B.Sc., M.S., F.R.C.S.

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A 51-year-old woman with a known history of polycystic disease of the liver and kidneys presented with jaundice and abdominal pain. A Tc-99m mebrofenin hepatobiliary scan showed a 'Cupid-heart' shaped area of uptake in the right iliac fossa and pelvic cavity, which persisted throughout the study. CT scan images showed replacement of the left lobe and most of the right lobe of the liver with multiple-sized cysts, except for the inferior parts allowing for the unusual appearance. The scintigraphic diagnosis of cholestatic intrahepatic biliary obstruction was confirmed on laparotomy. This was associated with extra hepatic obstruction treated with hepaticojejunostomy.

From the Departments of Nuclear Medicine* and Surgery,† Derriford Hospital, Plymouth, United Kingdom

Received for publication October 29, 1996; revision accepted December 4, 1996.

Reprint requests: Adil M. AL-Nahhas, M.Sc., M.R.C.P., Department of Nuclear Medicine, Derriford Hospital, Plymouth PL6 8DH, United Kingdom.

© Lippincott-Raven Publishers