Regional Liver Disorder with Differences in the Accumulation of (99m)Tc-phytate and (99m)Tc-galactosyl Human Serum Albumin

We report a 56-year-old woman with regional liver disorder due to acute hepatitis. Computed tomographic images showed low signal density at a plain phase and prolonged contrast effect at a late phase in the left hepatic lobe, in which an accumulation of (99m)Tc-phytate increased, whereas that of (99m)Tc-galactosyl human serum albumin (GSA) decreased. Meanwhile, in the right lobe, an accumulation of (99m)Tc-GSA showed more increased than that of (99m)Tc-phytate. Liver biopsy showed massive hepatocyte necrosis and interface hepatitis in the left lobe, and moderate hepatitis in the right lobe. Differences in the accumulation between these scintigrams were helpful for understanding rapid necrosis in the left lobe, resulting in a compensatory enlargement of the right lobe. Clinicians should be aware that some cases of acute hepatitis cause regional liver disorder although most cases show homogeneous inflammation.