Usefulness of Technetium-99m-2-methoxy-isobutyl-isonitrile liver scintigraphy for evaluating disease activity of non-alcoholic fatty liver disease
Usefulness of Technetium-99m-2-methoxy-isobutyl-isonitrile liver scintigraphy for evaluating disease activity of non-alcoholic fatty liver disease
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Technetium-99m-2-甲氧基-异丁基-异腈肝脏闪烁扫描在评估非酒精性脂肪肝疾病活动性中的用途
DOI：
10.1111/j.1872-034x.2011.00923.x
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发表时间：
2012
期刊：
影响因子：
4.2
通讯作者：
Saibara T
中科院分区：
文献类型：
--
作者：
Masuda K;Ono M;Fukumoto M;Hirose A;Munekage K;Ochi T;Okamoto N;Akagi N;Ogawa Y;Saibara T
目的：非酒精性脂肪性肝炎（NASH）是非酒精性脂肪肝病（NAFLD）的一种进行性形式。因此，评估疾病活动性并将 NASH 与 NAFLD 中的单纯脂肪变性区分开来非常重要。 Technetium-99 m-2-甲氧基-异丁基-异腈（99mTc-MIBI）是一种亲脂性阳离子，设计用于心肌灌注闪烁扫描诊断缺血性心脏病，其保留反映了线粒体功能。据报道，肝线粒体异常将是 NASH 疾病进展的重要预测因素。本研究的目的是检验 99mTc-MIBI 肝脏显像在评估 NAFLD 疾病活动性以及区分 NAFLD 患者 NASH 和单纯性脂肪变性方面的临床实用性。 方法：纳入了 26 名经活检证实的 NAFLD 患者。进行了临床实验室测试和 99mTc-MIBI 肝脏闪烁扫描。为了评估肝脏摄取，在肝脏和心脏处设置感兴趣区域，并计算肝脏与心脏的摄取比（肝脏/心脏比）。结果：所有NAFLD患者根据NAFLD活动评分分为三组：非NASH（单纯性脂肪变性）（n= 4）、边缘性NASH（n= 11）和NASH（n= 11）。 NASH 患者的肝/心比值显着低于单纯性脂肪变性患者 (P< 0.05)。此外，肝心比值与患者NAFLD活动评分显着相关（r = −0.413，P< 0.05）。结论：本研究表明99mTc-MIBI肝脏显像将是一种有用的非侵入性功能成像方法，可用于评估NAFLD疾病活动性并区分NASH与单纯性脂肪变性。
Aim:Non‐alcoholic steatohepatitis (NASH) is a progressive form of non‐alcoholic fatty liver disease (NAFLD). Therefore, it is important to evaluate disease activity and distinguish NASH from simple steatosis in NAFLD. Technetium‐99 m‐2‐methoxy‐isobutyl‐isonitrile (99mTc‐MIBI) is a lipophilic cation designed for myocardial perfusion scintigraphy in the diagnosis of ischemic heart diseases, and its retention reflects mitochondrial function. It was reported that hepatic mitochondrial abnormalities would be an important predictive factor for NASH disease progression. The aim of this study was to examine the clinical usefulness of99mTc‐MIBI liver scintigraphy for evaluating disease activity of NAFLD and distinguishing NASH from simple steatosis in patients with NAFLD.Methods:Twenty‐six patients with biopsy‐proven NAFLD were enrolled. Clinicolaboratory tests and99mTc‐MIBI liver scintigraphy were performed. To evaluate hepatic uptake, regions of interest were set at the liver and heart, and the uptake ratio of the liver to heart (liver/heart ratio) was calculated.Results:All patients with NAFLD were classified into three groups according to the NAFLD activity score: non‐NASH (simple steatosis) (n= 4), borderline NASH (n= 11), and NASH (n= 11). Liver/heart ratios were significantly lower in NASH than in simple steatosis (P< 0.05). Moreover, liver/heart ratios were significantly correlated with NAFLD activity scores among the patients (r = −0.413,P< 0.05).Conclusions:The present study indicates that99mTc‐MIBI liver scintigraphy would be a useful non‐invasive functional imaging method with which to evaluate disease activity of NAFLD and distinguish NASH from simple steatosis.