Hepatic visualization with a "hot" spot adjacent to the porta hepatis in Tc-99m MAA venography of the lower extremity: a sign of IVC obstruction.

A patient with suspected leg vein occlusion underwent 99mTc-MAA and 99mTc-pertechnetate venographies. The former study showed faint visualization of the liver associated with a large "hot" spot near the porta hepatis, a secondary sign of inferior vena cava obstruction, whereas the latter study did not demonstrate such findings. It is emphasized that the usage of 99mTc-MAA for venography, in addition to allowing detection of pulmonary embolism, has the advantage of visualization of the liver to strengthen the diagnosis of inferior vena cava obstruction.