"Hot spot" on liver scan due to tricuspid insufficiency

A patient with a diagnosis of tricuspid insufficiency was found to have a small focal area of increased activity, or "hot spot," in the liver on a Tc-99-sulfur colloid scan. This "hot spot" was in the superior central portion of the liver in the region of the junction of the hepatic veins and inferior vena cava. Its presence was confirmed on a dynamic study of the liver, which showed appearance of the activity in the abnormal area at the same time as in the right atrium. The finding was thought to be the result of reflux of blood from the right atrium into the vena cava and hepatic veins due to tricuspid insufficiency.