Overestimation of splenic size and underestimation of hepatic size by radiocolloid scintigraphy in advanced cirrhosis of the liver: an autopsy correlation.

The radiocolloid liver-spleen scintigrams of seven patients with advanced cirrhosis of the liver were correlated with autopsy results. The data showed scintigraphic overestimation of splenic size and underestimation of hepatic size. The causes of underestimation of the liver size were: rotation of the liver due to ascites; photon attenuation by ascitic fluid; and/or decreased and in homogeneous distribution of radiocolloid in the diseased liver. The splenic size/weight was overestimated because of lack of the effects of ascites and the usually marked increase in splenic radioactivity. Awareness of the underestimation of the liver weight/size and overestimation of the splenic weight/size occurring on the radiocolloid liver-spleen scan of patient with advanced alcoholic cirrhosis of the liver may help avoid misinterpretation.