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Portal Shunt Scintigraphy (PSS) in the Evaluation of Patients Suspected of Hereditary Hemorrhagic Telangiectasia

Nozawa, Asae MD; Miller, Frank J. MD; Rivandi, Ali Hosseini MD; Hoh, Carl K. MD

doi: 10.1097/RLU.0b013e31829a0164
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Vascular malformations of the liver in hereditary hemorrhagic telangiectasia may develop high output cardiac failure. Currently, the treatment for refractory hepatic vascular shunts includes hepatic artery embolization. However, hepatic or biliary necrosis may occur if inadequate portal blood flow supplies the liver. In this study, we applied noninvasive portal shunt scintigraphy to determine the portal shunt index for their evaluation. We present a case of the patient with a high PSI value and another case with a normal PSI value (<10%).

From the Department of Radiology, University of California, San Diego, San Diego, CA.

Received for publication January 25, 2013; revision accepted April 15, 2013.

Conflicts of interest and sources of funding: This work was supported in part by the Wagner Torizuka Fellowship Program to A.N.

Reprints: Carl K. Hoh, MD, UCSD Medical Center, 200 W. Arbor Dr. San Diego, CA 92103-8758. E-mail:

© 2013 by Lippincott Williams & Wilkins