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Figure 15. Focal fatty infiltration. Ultrasound performed for abdominal pain in this 27 year old woman showed a 4 x 5 cm. echogenic focus in the liver. A noninfused CT (a) shows a localized area of hypodensity in the medial segment of the left lobe of the liver (arrow). A traversing vessel appeared undisplaced suggesting focal fatty infiltration rather than a mass, but the appearance was not definitive. Transaxial (b) and coronal (c) 99mTc-sulfur colloid images show uniform activity confirming a benign process.

Figure 15. Focal fatty infiltration. Ultrasound performed for abdominal pain in this 27 year old woman showed a 4 x 5 cm. echogenic focus in the liver. A noninfused CT (a) shows a localized area of hypodensity in the medial segment of the left lobe of the liver (arrow). A traversing vessel appeared undisplaced suggesting focal fatty infiltration rather than a mass, but the appearance was not definitive. Transaxial (b) and coronal (c) 99mTc-sulfur colloid images show uniform activity confirming a benign process.

Lack of displacement of vessels and the characteristics of fat on MRI are helpful in the diagnosis in both situations. Kupffer cells are unaffected and the liver appears homogeneous on 99mTc-sulfur colloid imaging (Fig 15).

Frequently Asked Questions (FAQs)

Can scintigraphy predict whether or not a patient's atypical chronic symptoms are related to the presence of known gallsti ones:

No. Gallstones are common and do not necessarily result in symptoms. Delayed visualization or nonvisualization of the gallbladder or abnormal emptying can certainly be seen in asymptomatic patients. The value of these scintigraphic findings in predicting who will have a favorable response to cholecystectomy is unknown. Clinical assessment as to the nature of the pain is the most reliable predictor.

Does nonvisualization of the gallbladder in a patient with acute RUQpain confirm the presence of acute cholecystitis?

No. Visualization of the gallbladder effectively excludes acute calculous cholecystitis. Cystic duct obstruction in the absence of acute inflammation, a contracted gallbladder filled with stones, inadequate fasting, impaired liver function, and other acute intra-abdominal disease can also result in nonvisualization. Focal

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Get Rid of Gallstones Naturally

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