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Reversibility of Intrapulmonary Arteriovenous Shunts in Liver Cirrhosis Documented by Serial Radionuclide Perfusion Lung Scans

Using serial perfusion lung scans, we have documented the opening up and closure of right-to-left intrapulmonary arteriovenous shunts over a period of several weeks in a patient with chronic alcoholic liver disease. The presence of the shunts correlates well with the severity of hypoxemia and the presence of nodular mottling on chest radiographs. The time course of these changes with clinical status suggests lability and the functional nature of these shunts.