Correlation of scintiangiography and Gray-scale ultrasonography in differentiating the space occupying lesions of the liver

The standard liver scintiscan with Tcsup(99m) colloid is a diagnostic method of limited value, since the nature of the defects detected by it cannot be clarified. To this point, significant diagnostic help can be contributed by scintiangiography, especially in defects due to primary liver neoplasms since scintiangiography can detect the ''arterialization'' of the lesion. On the other hand in cases of metastatic liver tumors there is variability in the scintiangiographic findings. In the material studied 5 out of 19 cases of metastatic liver tumors showed increased blood supply of the affected area during the arterial phase, whereas 14 showed a pattern compatible with cystic liver lesions. The use of Gray-scale ultrasonography allowed to differentiate true cystic lesions from those metastatic ones with decreased blood supply in both phases of the scintiangiogram. Thus, while all the patients with cystic liver lesions had no internal echos in the Gray-scale ultrasonography, patients with metastatic and primary liver tumors had solid or mixed elements. The correlation of scintiangiography and Gray-scale ultrasonography can critically help in differentiating cystic liver lesions from metastatic tumors and those of primary with decreased blood supply