THE VALUE OF LIVER SCANNING IN THE DIAGNOSIS OF POLYCYSTIC DISEASE OF THE LIVER

¹ From the Second Surgical Clinic (Head: Professor Martti Turunen, M.D.) and the Radiotherapy Clinic (Head: Professor Sakari Mustakallio, M.D.) of the University Central Hospital, Helsinki, Finland

Liver scanning with 100 µc of colloidal Au ¹⁹⁸ was carried out in 26 patients with polycystic liver. The examination gave very useful information about the size, location and number of the cysts. A definite pathologic condition was noted in 80 per cent of the patients. Only cysts which were small (under 3 cm.) and scattered throughout the liver escaped detection.

A patient with clinically established polycystic liver is in very good condition. The large liver may be tuberous under the costal margin on palpation. It has grown gradually during a period of years and causes no symptoms other than a feeling of weight and fullness in the epigastrium. Despite the very great size of the liver, the laboratory tests are usually normal. Roentgen examination also gives only indirect support to the diagnosis of the disease. The dome of the diaphragm may be lobulated and elevated; calcification shadows caused by the cysts may sometimes be seen; anti displacement of the adjacent organs may be demonstrated.

By combining liver scanning with these examinations we seldom need to resort to investigations which expose the patient to a greater risk and a heavier strain, such as laparoscopy or laparotomy, when looking for a polycystic liver.

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