Synonyms Liver Scintigraphy; Liver-Spleen Scan; Radioisotope Hepatic Scan; Radionuclide Liver Scan; Spleen Scan

Procedure Commonly Includes The patient receives an intravenous injection of a technetium-99m (^99mTc) colloidal radiopharmaceutical which is rapidly accumulated in reticuloendothelial cells of the liver and spleen. Shortly after the injection, multiple images of the liver and spleen are acquired. An initial dynamic flow study may also be acquired to assess hepatic and/or splenic perfusion, especially in cases of trauma.

Indications Liver and spleen imaging is an accurate noninvasive method to delineate overall organ size, the presence of focal lesions, and/or the degree of hepatocellular dysfunction in diffuse liver disease. It has been used to detect and document later resolution of traumatic splenic hematomas or infarcts.

Patient Preparation Patient should have all RIA blood work performed, or at least drawn, prior to injection of any radioactive material. The patient does not need to be fasting or NPO for this procedure.

Special Instructions Requisition must state the current patient diagnosis in order to select the most appropriate radiopharmaceutical and/or imaging technique. Schedule a liver scan at least 1 day before a bone scan if both are ordered for the same patient. DURATION OF PROCEDURE: 30 minutes to 1 hour RADIOPHARMACEUTICAL:^99mTc sulfur colloid or other microcolloid compound

Technique The application of single-photon emission tomography (SPECT) techniques may contribute significantly to the diagnostic accuracy of this imaging study.

Causes for Rejection Residual barium in GI tract from recent x-rays, other recent Nuclear Medicine procedure may interfere. If uncertain, call the Nuclear Medicine Department.

Turnaround Time A written report will be sent to the patient's chart and/or to the referring physician.

Normal Findings Homogeneous distribution of activity throughout both liver and spleen with no organomegaly or focal defects. The ratio of spleen:liver activity should be about equal. Increased relative splenic uptake, especially if accompanied by visualization of bone marrow reticuloendothelial uptake, indicates at least some degree of hepatocellular dysfunction.

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