Evaluation of Hepatic Hydrothorax by 99mTc-MAA Peritoneal Scintigraphy

Araya Boonyaleepan

doi:10.46475/aseanjr.v18i3.115

Authors

Araya Boonyaleepan, M.D. Nuclear Medicine section, Department of Nuclear Medicine, Rajavithi Hospital

DOI:

https://doi.org/10.46475/aseanjr.v18i3.115

Abstract

Background: Hepatic hydrothorax occurs 6-10% of advance cirrhotic patient. If we can diagnosed quickly and accurately, it can present the patients from unnecessary investigations and early start correct treatment.

Objective: To evaluate the results of using ^99mTc-MAA peritoneal scintigraphy for demonstrate peritoneo-pleural communication in the patients with suspected hepatic hydrothorax.

Material and Method: Descriptive retrospective study. Collected and analized data of the cirrhotic patients who was investigated by ^99mTc-MAA peritoneal scintigraphy in nuclear medicine section , Rajavithi hospital , Thailand from 2005-2012.

Results: Eleven patients were identified, 7 male and 4 female average age 52.55 years. Most common cause of cirrhosis was viral hepatitis C (45%) and almost all (10/11) were in child class C. 88% of patient who was evaluated by gastroscope had esophageal varies. 91% of patients had ascites which 90% were massive , 20% moderate and 10% small amount. Peritoneal scintigraphy were positive in 7 patients , excluded a patient who was suspected cause of pleural effusion form pulmonary infection , percent of demonstrated peritoneo-pleural communication was 70. A patient who didn’t have ascites also had positive scintigraphy. Time since radiotracer administration until it appears in pleural cavity was less than 1 hour in 57% of patients, 2 hours 14.3% , 4 hours 14.3% and 24 hours 14.3%

Conclusion: ^99mTc-MAA peritoneal scintigraphy is a safe , rapid, cheap, minimally invasive and low radiation method for evaluation of the patients who was suspected hepatic hydrothorax with medium positive results (70%) and high specificity

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