To determine whether the liver-scan findings previously shown to be related to portal-systemic collateral circulation occur only in patients with fibrotic liver disease, 567 hepatic scans with gold Au 198 performed over a six-year period were reviewed. Observance for liver "mottling," splenic uptake, or bone-marrow uptake of the isotope showed that one or more of these abnormalities was present in 51 (9.0%) of the patients. Evidence of portal-systemic collateral circulation on scan was most prominent in hepatic cirrhosis (76.6%); extrahepatic malignancies, acute and chronic hepatitis, hereditary hemorrhagic telangiectasia, and chronic lung disease accounted for the remainder. Evidence of portal-systemic shunting is most common in cirrhosis, and, when seen in the noncirrhotic patient, occurs when portal hypertension and hepatic collateral circulation are likely to be present.