Staging of portal hypertension and portosystemic shunts using dynamic nuclear medicine investigations

Figure 1 Per-rectal portal scintigraphy dynamic curves. Separate analyses of the two liver lobes for a cirrhotic patient (stage 4b).

Figure 2 Per-rectal portal scintigraphy. A: Stage 0, normal aspect. LTT = 24 s, PRSI < 5%; B: Stage 1. LTT increased (33 s). PRSI < 5%; C: Stage 2. Decreased LTT (18 s), PRSI slightly increased (8%); D: Stage 4c. Time between heart and liver curves is equal to RHTL = 42 s. Cirrhosis with undetectable portal inflow to the both lobes.

Figure 3 Liver angioscintigrahy. A: Normal aspect. HPI = 30%. G1 = arterial inflow segment; G2 = portal inflow segment; B: Cirrhotic patient. HPI = 60%; C: Cirrhosis with reversed portal flow. HPI = 130%.