Colloid scintigraphy in non-alcoholic steatohepatitis: A conventional diagnostic method for an emerging disease
Colloid scintigraphy in non-alcoholic steatohepatitis: A conventional diagnostic method for an emerging disease
复制标题
非酒精性脂肪性肝炎的胶体闪烁扫描：新发疾病的常规诊断方法
DOI：
10.1097/01.mnm.0000203629.15784.2e
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发表时间：
2006
影响因子：
1.5
通讯作者：
N. Tözün
中科院分区：
文献类型：
--
作者：
D. Duman;F. Dede;H. Akin;F. Şen;H. Turoğlu;Ç. Çelikel;N. Tözün
非酒精性脂肪性肝炎(NASH)是一种以弥漫性脂肪浸润和枯否细胞功能障碍为特征的进展性肝病，其发病机制与NASH的发病机制有关。由于肝活检被认为是诊断NASH的“黄金标准”，有一些局限性，其他成像方法也被探索为替代方法。胶体闪烁照相是反映Kupffer细胞活性的一种很好的方法，我们发现这项技术值得在NASH中进行评估。我们的目的是介绍NASH的常见核素扫描特征及其临床病理相关性。方法对22例新发的NASH患者(女性11例，平均年龄43.7±10.8岁)进行胶体肝显像检查。静脉注射185MBq99mTcTiN胶体后，分别进行动态、静态和SPECT扫描。结果： -MBq99mTcTiN胶体后，动态、静态和单光子发射计算机断层扫描均可显示。测定肝脏灌注量、血池清除时间、胶体向脾和骨髓的移位，并计算肝右/左叶比值。结果静态图像与断层(SPECT)图像计算值具有良好的相关性。所有患者的肝左/右叶比值均发生改变。7例(32%)患者血池清除时间延长，但所有患者的肝脏灌注量均正常。在SPECT分析中，55%的患者观察到胶体向脾转移。未观察到核素扫描参数与组织学或生化结果之间的相关性。结论肝左/右叶比值改变是本组NASH患者普遍存在的临床表现。NASH的其他常见核素扫描特征包括胶体向脾转移和血池清除时间延长。肝脏核素扫描可能是治疗试验中NASH患者随访的一种有前途的非侵入性工具。
AimNon-alcoholic steatohepatitis (NASH) is a progressive liver disease characterized by diffuse fatty infiltration and Kupffer cell dysfunction which contributes to its pathogenesis. Since the liver biopsy, which is considered the ‘gold standard’ in diagnosing NASH, has some limitations other imaging methods have been explored as alternatives. Colloid scintigraphy is a good method reflecting Kupffer cell activity and we found it worthwhile to evaluate this technique in NASH. We aimed to present the common scintigraphic features and their clinicopathologic correlations in NASH. MethodsTwenty-two new patients (11 female, mean age 43.7±10.8) with biopsy-proven NASH underwent colloid liver scintigraphy. The dynamic, static and SPECT images were performed after intravenous injection of 185 MBq 99mTc tin colloid. Hepatic perfusion, blood pool clearance time, colloid shift to spleen and bone marrow were assessed and liver right/left lobe ratio was calculated. ResultsThe values calculated on static and tomographic (SPECT) images showed good correlation. Liver right/left lobe ratio was altered in all patients. Blood pool clearance time was prolonged in seven (32%) but hepatic perfusion was normal in all patients. Colloid shift to the spleen was observed in 55% of patients using SPECT analysis. No correlation between scintigraphy parameters and histological or biochemical findings were observed. ConclusionAltered liver right/left lobe ratio was the universal finding in all our NASH patients. Other common scintigraphic features of NASH include colloid shift to spleen and prolonged blood pool clearance time. Liver scintigraphy might be a promising non-invasive tool in the follow-up of NASH patients in therapeutic trials.