Hepatic imaging in diffuse liver disease.

An analysis of hepatic imaging (liver-spleen scintigraphy, ultrasonography, and computed tomography) was performed in 91 patients prospectively referred for percutaneous liver biopsy for suspected chronic liver disease. Hepatic imaging was performed in 51 of 91 patients (56%). Of these 51 patients, 42 (82%) underwent radionuclide imaging, whereas only seven (14%) underwent ultrasonography and only two (4%) underwent computed tomography performed. Scintigraphy revealed evidence of diffuse liver disease in 40 of 42 patients (95%) vs 0 of 7 patients (0%) for ultrasonography (P less than 0.0001). The frequency of imaging varied significantly by prebiopsy presumptive diagnosis, but this pattern was primarily a reflection of patient age. Imaging was performed in 76% of patients over 50 years of age vs 37% of patients below this age (P less than 0.001). In the hospital, scintigraphy is still prominently used as a screening tool before referral for percutaneous liver biopsy. Justification of this use involves multiple reasons beyond simply a diagnosis.