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Focal fatty infiltration of the liver in acute alcoholic liver injury: hot spots with radiocolloid SPECT scan.

We present herein a case of focal fatty infiltration of the liver, in which extremely unusual findings were exhibited on single-photon emission computed tomography (SPECT) of the radiocolloid liver scan. Liver scan was performed on a 46-yr-old patient with a clinical picture of acute alcoholic hepatitis. Multiple hot spots were demonstrated by SPECT scan, and these lesions corresponded to focal fatty infiltration, which were proven by computed tomography (CT). These hot spots disappeared rapidly in accordance with the improvement in fatty change on CT, and with the improvement in the clinical picture. The hot spots in this case were believed to represent the nonuniform intrahepatic shuntings, which presumably caused the development of focal fatty infiltration as well. SPECT may be useful in detecting and monitoring the alteration of hepatic circulation in alcoholic patients with focal fatty infiltration of the liver when planar colloid liver scan shows a mottled pattern.