The heterogeneous liver scan: ultrasound correlation

Fifty-five heterogeneous technetium-99m sulfur colloid liver scans of 48 patients with suspected metastatic disease were compared with gray scale ultrasound results. Of the 52 ultrasound scans corresponding to the nuclear scans with mild to moderate heterogeneity, 35 (67%) were normal, 11 (21%) were consistent with hepatocellular disease, 3 were incomplete because of abdominal gas, and 2 were false positive studies interpreted as suspicious for tumor. Ultrasound is not recommended for searching for space-occupying lesions when the nuclear scan is mild to moderately heterogeneous; it did detect the presence of tumor in 1 of 3 patients with severely "mottled" nuclear scans.