Using state-of-the-art technology in nuclear medicine and ultrasound, directed ultrasound examinations were performed with attention to equivocal areas identified on hepatic isotope studies. In 100 patients studied prospectively, 100 equivocal radionuclide findings were identified. Proven diagnoses were obtained in 99 cases. Overall accuracy figures were 74% for scintigraphy and 93% for ultrasound. Scintigraphy in general showed high sensitivity, but ultrasound showed greater specificity and accuracy. It was concluded that a directed ultrasound examination is accurate and useful when the hepatic scintigraph is equivocal for any reason.