Transient Tc-99m MDP Hepatic Uptake Induced by Acute Hypoxic Hepatitis

Bykov, Sergey; Garty, I.; Bisharat, Naiel

doi:10.1097/00003072-200106000-00018

Cited by 7 publications

(1 citation statement)

References 5 publications

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“…Diffuse liver uptake of bone tracer has been reported in cases of diffuse liver damage due to a variety of etiologies including massive hepatic necrosis associated with iron therapy, Budd-Chiari syndrome, cocaine hepatotoxicity, acute hypoxic hepatitis, ischemic hepatopathy, and high-dose methotrexate chemotherapy (31,32,33,34,35). Hepatic and other ectopic soft tissue calcifications have also been reported following LT (36).…”

Section: Discussionmentioning

confidence: 99%

Osseous and Nonosseous Bone Scan Findings in Liver Transplant Candidates with end-stage Chronic Liver Disease

Erhamamci¹,

Aktaş²,

Bahçeci³

et al. 2013

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Objective: End-stage chronic liver disease (CLD) adversely affects the function of multiple organ systems including the skeletal system. The aim of this study was to assess osseous and nonosseous bone scintigraphy (BS) findings in liver transplant (LT) candidates with end-stage CLD.Methods: We retrospectively evaluated BS findings in 50 consecutive patients with end-stage CLD who were undergoing preoperative assessment for LT from January 2006 to December 2011. All the patients were analyzed with respect to clinical and laboratory parameters, and BS findings. Scintigrams were visually assessed for the presence of osseous and nonosseous abnormalities. Osseous abnormalities were classified as those indicating bone metabolism changes or metastatic bone disease. Typical scintigraphic findings denoting to changes in bone metabolism were the presence of decreased osseous uptake, increased periarticular uptake, asymmetrical or unusual uptake patterns. Nonosseous findings were classified according to the degree of soft-tissue uptake as mild and severe.Results: The group consisted of 46 adult and 4 adolescent patients. All adolescent patients had normal skeletal accumulation with growth plate uptake and one had mildly increased renal cortical activity. A total of 46 adult patients had one or more of the following osseous findings: generalized decrease in osseous uptake (n=4, 8.7%); bilateral decrease in lower extremity uptake (n=26, 56.5%); symmetrically increased periarticular uptake (n=26, 56.5%); bilateral cortical/periosteal increased uptake in the lower extremity indicating hepatic hypertrophic osteoarthropathy (HOA) (n=8, 17.4%); bilateral increased sacroiliac activity (n=16, 34.8%); sacral activity (n=10, 21.7%), coccygeal activity (n=2, 4.3%), focally increased uptake suggestive of metastases (n=5, 10.9%). Three rib metastases appeared to be linear. Nonosseous findings observed in adult patients were mild diffuse liver uptake (n=4, 8.7%) and bilateral diffuse mild or severe degree of renal cortical uptake (n=20, 43.5%). There was a statistically significant difference in serum creatinine values between mild and severe renal uptake groups (p<0.05). There was also statistically significant difference in serum BUN and creatinine values between patients with severe degree of renal uptake and without renal uptake (p<0.05).Conclusion: The results of the current study has shown that adolescent LT candidates with end-stage CLD had no osseous abnormality on BS. However, all of adult patients exhibited one or one more osseous abnormalities. Typical scintigraphic findings denoting to abnormalities in bone metabolism were generalized decreased osseous uptake, decreased lower extremity osseous uptake, increased periarticular uptake, increased cortical/periosteal uptake indicating hepatic HOA, and other unusual uptake patterns. Hepatocellular carcinoma metastases may present itself as rib metastases linear in pattern. Soft-tissue uptake in the form of diffuse bilateral mild or severe degree of renal uptake and less commonly mil...

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Section: Discussionmentioning

confidence: 99%

Osseous and Nonosseous Bone Scan Findings in Liver Transplant Candidates with end-stage Chronic Liver Disease

Erhamamci¹,

Aktaş²,

Bahçeci³

et al. 2013

MIRT

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Pathologic hepatic Tc-99m-MDP uptake in polyostotic fibrous dysplasia

et al. 2004

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Fibrous dysplasia of bone is a congenital, sporadic developmental disorder characterized by immature fibrous connective tissue and bone deformities. Hepatic Tc-99m-MDP uptake is a rare, serendipitous finding during bone scanning studies. The present patient was a 25-year-old male who had severe polyostotic fibrous dysplasia. On Tc-99m-MDP (methylene diphosphonate) bone scintigraphy, increased activity accumulations were seen on multiple ribs, vertebrae and base of the cranium. In addition, diffuse increased pathologic uptake of Tc-99m-MDP in the liver was shown. Intravenous pamidronate was administered monthly for two months. In the third week of the last administration Tc-99m-MDP bone scintigraphy was performed again, but despite sustained bone involvement, pathologic hepatic uptake was not seen on the scan. We thought that pathologic hepatic Tc-99m-MDP accumulation, may be related to the formation and aggregation of calcium oxalate and phosphate crystals which improved with pamidromat treatment.

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