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A case of massive hepatic necrosis has been found to have intense, diffuse accumulation of Tc-99m HMDP in the liver. A review of three similar cases revealed that diffuse intense uptake of bone-scanning agents is a grave prognostic sign.

This case report illustrates the demonstration of pleural-peritoneal communication in a patient with a malfunctioning LeVeen shunt by a simple, noninvasive radionuclide technique. The patient was a 54-year-old woman who had had a LeVeen shunt placed for the treatment of intractable ascites. Tc-99m-sulfur colloid was injected intraperitoneally, and the scan showed concentration of the tracer in the pleural space, thus confirming pleural-peritoneal communication.

A case of malignant mesothelioma is presented with marked radionuclide accumulation in the periphery of the hemithorax on Ga-67 imaging.

Seat-belt injuries to the neck in a traffic accident or any trauma to the neck in other situations can cause tearing of the inner surface of the carotid arteries and lead to the formation of a fresh thrombus, or can cause partial to complete transection of the carotid arteries.

Regional enteritis in a 41-year-old woman was localized on a 67Ga-citrate scan, appearing as a well-circumscribed abnormality in the pelvis simulating an abscess or a malignant neoplasm. Gallium-67-citrate scintigraphy is useful in localizing granulomatous inflammations including regional enteritis, and its use may be beneficial in evaluating the extent and the state of disease process.

A comparison of bone scintigrams and roentgenographic skeletal surveys, obtained on 170 patients with breast carcinoma, was made to evaluate the diagnostic efficacy of these techniques in detecting metastatic bone lesions. The bone scans were abnormal in 81 patients, while the roentgenograms were abnormal in only 51. In 34 of the 81 (42%) patients with abnormal bone scans, there was no radiographic evidence of a benign lesion to account for the increased ratiotracer uptake; and the abnormalities noted on the bone scans were proven to be bony metastases on follow-up examinations. In the remaining 47 patients with positive bone scintigrams, both the scans and the roentgenograms were abnormal; however, in 23 patients the bone scan demonstrated significantly more lesions than what the roentgenograms had revealed. This study confirms that bone scan is superior to roentgen surveys in detecting skeletal metastases in patients with breast carcinoma. It was noted that the metastatic lesions can be visualized on the scans earlier than they are apparent on the X-rays by a mean interval of 4 months.

A case of a parathyroid cyst with adenoma was seen on Tl-201/Tc-99m subtraction imaging. The literature regarding parathyroid cysts and the subtraction technique for parathyroid adenoma imaging was reviewed.

When numerous defects are demonstrated in the liver scan of a patient confirmed as having malignant tumor, metastatic disease of the liver can usually be easily diagnosed. However, the scan must be interpreted with caution because extrinsic tumor compression often mimics metastatic disease.