False-positive liver scans due to portal hypertension: correlation with percutaneous transhepatic portograms in 33 patients

Tc-99m-phytate scanning of the liver and percutaneous transhepatic catheterization of the portal vein were performed in 33 patients--26 with cirrhosis, 3 with chronic active hepatitis, 2 with idiopathic portal hypertension, and 2 with unresolved acute hepatitis. A discrete defect in the porta hepatis area was seen in 6 of 28 patients who had portal vein pressure above 200 mm H2O. In 5 of the 6 patients with a false-positive scan, the umbilical portion of the left portal vein branch was dilated (larger than 25 x 20 mm) on the portogram, with or without a patent paraumbilical vein. The anatomical basis of this phenomenon is discussed, and it is suggested that this area be given special attention