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Local Colloid Trapping in the Liver in the Inferior Vena Cava Syndrome

Veterans Administration Medical Center and St. Louis University, St. Louis, Missouri

Correspondence: For reprints contact: Max S. Lin, MD, PhD, Nuclear Medicine Service (115JC), VA Medical Center, St. Louis, MO 63125.

ABSTRACT

Local radioactive areas in the liver were observed as a result of superficial cavoportal shunting of radiocolloids in two patients with the inferior vena cava syndrome. In one patient a paraumbilical and/or a recanalized umbilical vein was apparently involved in the hepatopetal shunting. In the other patient a superficial anastomosis other than the paraumbilical vein shunted colloid to the liver. Relatively discrete areas of increased radioactivity, single or multiple, were seen in the left lobe. Virtually all reported instances of hepatopetal shunting of radioparticles in a superior or an inferior vena cava syndrome have demonstrated similar findings. Various hepatopetal collateral pathways in infrarenal caval obstruction are considered, and factors that could affect liver scan findings in the infrarenal obstruction are discussed.