Scintigraphic features of cavernous transformation of the portal vein

A case of portal vein obstruction with cavernous transformation is presented, in which findings on both Tc-99m-sulfur colloid and HIDA liver scintigrams suggested the diagnosis. These findings included a focal hyperconcentration of colloid on the former and notching of the common bile duct as well as "draping" of the right hepatic duct on the latter. All of these findings were shown at angiography and surgery to be secondary to extensive venous collateral vessels related to portal vein obstruction.