Diagnosis of Hepatic Hydrothorax by Tc-99m Sulfur Colloid Peritoneal Scintigraphy

Hepatic hydrothorax: Pathophysiology diagnosis and management

“…In cases where the diagnosis of hepatic hydrothorax is in doubt, in particular when pleural effusion is left sided and/or ascites are absent an intraperitoneal administration of 99m Tc‐human serum albumin or 99m Tc‐sulfur colloid should be performed. The migration of the radioisotope into the pleural cavity within hours confirms the presence of a communication between the pleural and peritoneal spaces 32–34 . According to a recent study, this technique has sensitivity and specificity rates of 71% and 100%, respectively 35 .…”

“…The migration of the radioisotope into the pleural cavity within hours confirms the presence of a communication between the pleural and peritoneal spaces. [32][33][34] According to a recent study, this technique has sensitivity and specificity rates of 71% and 100%, respectively. 35 Moreover, it can be used even in the absence of ascites, through the ultrasound-guided administration of the radiolabeled substance in a 500-mL volume of normal saline.…”

Early Diagnosis of Hepatic Hydrothorax with Associated Occlusion of a Peritoneo-Venous Shunt with Tc-99m MAA

“…Although the exact mechanisms are not fully understood, hepatic hydrothorax probably results from the passage of ascites from the peritoneal cavity into the pleural cavity through small diaphragmatic defects [5,6]. Though peritoneal scintigraphy with Tc-99m sulfur colloid can be used for detection of hepatic hydrothorax [7], our case demonstrated that Tc-99m MAA also can be used for this purpose, and was able to detect a minimal pleural effusion in the setting of severe uncontrolled ascites resulting from portal venous thrombosis. Though not as effective as replacing shunt, urokinase has been reported to be able to restore shunt patency [8].…”

Diffrential Diagnosis of Hepatic Hydrothorax by 99mTc Sulfur Colloid Peritoneal Scintigraphy: Two Cases

“…Later, scintigraphic images of abdomino-thoracic region are obtained by gamma camera. Using this technique, demonstration of the presence of a communication between abdomen and thoracic cavities can be quickly confirmed [9-11]. …”