Premium
USE OF 99M TCO TRANS‐SPLENIC PORTAL SCINTIGRAPHY FOR DIAGNOSIS OF PORTOSYSTEMIC SHUNTS IN 28 DOGS
Author(s) -
Morandi Federica,
Cole Robert C.,
Tobias Karen M.,
Berry Clifford R.,
Avenell James,
Daniel Gregory B.
Publication year - 2005
Publication title -
veterinary radiology and ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.541
H-Index - 60
eISSN - 1740-8261
pISSN - 1058-8183
DOI - 10.1111/j.1740-8261.2005.00030.x
Subject(s) - medicine , scintigraphy , radiology , nuclear medicine , portography , abdomen , splenic vein , portal vein , inferior vena cava , percutaneous , venography , portosystemic shunt , ultrasound , portal hypertension , surgery , cirrhosis , thrombosis
Ultrasound‐guided percutaneous trans‐splenic portal scintigraphy (TSPS) using 99m TcO has been used to image the portal venous system in normal dogs. Compared with per‐rectal portal scintigraphy, it provides higher count density, consistent nuclear venograms of the splenic and portal vein, and significantly decreased radiation exposures. This paper describes the use of TSPS for the diagnosis of portosystemic shunts in 28 dogs. TSPS was performed injecting 70±28 MBq of 99m TcO (mean±SD) into the splenic parenchyma with ultrasound guidance. A dynamic acquisition at a frame rate of four frames/s for 5 min was initiated after placement of the needle and approximately 2 s prior to injection. All dogs had diagnoses confirmed via exploratory laparotomy or ultrasonographic identification of the shunting vessel(s). Three studies (10.7%) were nondiagnostic because of intraperitoneal rather than intrasplenic injection of the radionuclide. Three pathways were recognized on the scintigraphic images: (1) portoazygos shunts—the 99m TcO bolus traveled dorsally, running parallel to the spine and entering the heart craniodorsally; (2) single portocaval or splenocaval shunts—the 99m TcO bolus ran from the area of the portal vein/splenic vein junction in a linear fashion toward the caudal vena cava entering the heart caudally; (3) internal thoracic shunt—the 99m TcO bolus traveled ventrally along the thorax and abdomen entering the cranial aspect of the heart. Single and multiple shunts were easily distinguished. There were no distinguishing features between single intra and extrahepatic portocaval shunts.