Prediction of satisfactory response to pleural sclerosis using radiopharmaceuticals: study in a patient with cirrhotic hydrothorax and LeVeen shunt.

Rapidly recurring right pleural effusion was a disabling clinical problem in a 51-year-old woman with alcoholic cirrhosis that had not been relieved by diuretic therapy or a LeVeen shunt. By injecting technetium Tc 99m albumin aggregated into the peritoneal cavity, shunt patency and rapid flow into the pleural effusion were demonstrated. In contrast, technetium Tc 99m albumin aggregated injected injected into the pleural fluid showed no movement into the abdominal cavity. These test results predicted that pleural sclerosis would help her clinical problem but would not place the abdominal contents in jeopardy. This prediction has proved to be correct.