Correlation of liver-spleen scan findings with modified Child-Pugh classification

The Child-Pugh classification is used as an index of liver function. We assessed the relationship between modified Child score and sulfur colloid liver-spleen scintigraphy in histologically confirmed cirrhosis.

Following injection of 185 MBq (99)mTechnetium-sulfur colloid, anterior and posterior images were obtained at 30 minutes with 500,000 counts. Liver-spleen scintigraphy pattern was divided visually into three categories: A (liver uptake >or= spleen uptake, without visualization of ribs and vertebrae), B (spleen uptake > liver uptake without visualization of ribs and vertebrae), and C (remarkable visualization of ribs and vertebrae).

Of 36 patients, 14 (38.8 %), 19 (58.8 %) and 3 (8.3 %) patients were categorized into Child-Pugh grades A, B and C, respectively, whereas 13 (36.1 %), 12 (33.3 %) and 11 (30.6 %) patients were categorized into scintigraphic grades A, B and C, respectively. In 14 patients the results of Child and scan classifications were in agreement, but in 22 patients the results were discordant. Kappa value was 0.072 (poor agreement).

There is no correlation between scintigraphic and Child-Pugh classifications. Scintigraphic classification may present a marker of body reactions to the disease, independent of Child-Pugh modified classification. Further studies are needed to determine which one of these classifications has better concordance with the patient's outcome.