Liver-spleen scanning in pediatrics.

Liver-spleen scans on 254 children were reviewed retrospectively with regard to accuracy 
and yield of examination. The scan predicted abnormality correctly 95% of 
the time and normality correctly 86% of the time. Pitfalls in 
interpretation include the nonspecificity of abnormalities present on the scan, confusion 
of extrinsic with intrinsic defects, and normal anatomical variations with pathology. 
The technetium-99m-sulfur colloid scan was found to be most helpful in 
diagnosing splenic abnormalities, in working up abdominal masses, and in evaluating 
tumor patients with a baseline scan. It was found least useful 
in patients with fever of unknown origin, abdominal pain, diffuse liver 
disease, and most inflammatory conditions. Liver abscesses were not found in 
febrile, otherwise healthy children. The iodine-131-rose bengal liver scan was found 
to be useful to differentiate potentially curable lesions (e.g., choledochal cysts) 
from those not surgically treatable. 