Characteristic cholescintigraphic images in space-occupying lesions

Patients with space-occupying lesions (SOL) were studied using cholescintigraphy and varying results found. In 24 cases of SOL of 40 patients studied, we observed: (1) the presence of focal defects; (2) displacement of the intrahepatic biliary tree; (3) blocking of the passage (stop) of radioactivity to the intrahepatic biliary tree. The first indication, the presence of focal defects, had a sensitivity of 0.81 and a specificity of 0.78. The displacement and radioactivity stop was less frequent, but more specific. This is due to the fact that cholescintigraphy permits the specific study of the biliary tree and its pathological alterations. In our patients, the diagnostic errors were due to extreme hepatic damage, which produced an unclear image of the liver parenchyma and the biliary tree. This is observed in complete obstruction and in some cases of cirrhosis. When signs of displacement and stop were closely associated with focal defects, the diagnosis of SOL was highly specific.