99mTc-GSA liver dynamic SPECT for the preoperative assessment of hepatectomy
99mTc-GSA liver dynamic SPECT for the preoperative assessment of hepatectomy
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DOI：
10.1007/bf02988261
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发表时间：
2003-02-01
影响因子：
2.6
通讯作者：
Ohkawa, M
中科院分区：
文献类型：
--
作者：
Satoh, K;Yamamoto, Y;Ohkawa, M
目的：本研究的目的是设计一个预测指标，以预测残余肝功能肝切除术前，使用锝-99 m-GSA（Tc-99 m-GSA）肝动态单光子发射计算机断层扫描（SPECT）。方法：对57例肝病患者进行99 mTc-GSA肝脏动态SPECT显像。根据99 mTc-GSA注射后的累积曲线进行动态SPECT以获得k值。k值是循环放射性示踪剂在肝细胞中累积时消失速率的数学反映。我们设计了一个原始的预测残留指数（PRI），结合k值与肝脏体积（V）和功能性肝脏体积（FV）。分析这些参数与肝功能检查结果和肝病严重程度的相关性。我们回顾性研究了PRI和术后患者预后之间的相关性。结果：k值与15 min吲哚菁绿色清除试验、胆红素水平和肝纤维化试验略有相关。FV和V与肝功能检查无相关性。术后并发症5例。这些患者的PRI均低于0.37。当PRI> 0.38时，无患者发生肝功能衰竭。结论：当PRI> 0.38时，肝切除术后发生肝功能衰竭的可能性较低。PRI可用于肝病患者肝切除术后残余肝功能的术前预测。
Objective: The purpose of the present study was to devise a predictive index to predict residual liver function before hepatic resection, using technetium-99m diethylenetriamine-penta-acetic acid-galactosyl human serum albumin (Tc-99m-GSA) liver dynamic single photon emission computed tomography (SPECT). Methods: Fifty-seven patients with liver disease underwent liver dynamic SPECT with 99mTc-GSA. Dynamic SPECT was performed to obtain the k-value according to the accumulation curve after injection of 99mTc-GSA. The k-value is a mathematical reflection of the rate of disappearance of the circulating radiotracer as it is accumulated into the hepatocytes. We devised an original predictive residual index (PRI) by combining k-value with liver volume (V) and functional liver volume (FV). Correlation between these parameters and results of liver function tests and the grade of liver disease severity was analyzed. We investigated retrospectively the correlation between PRI and post-operative patient prognosis. Results: The k-value slightly correlated with indocyanine green clearance test at 15 mins, bilirubin level and hepaplastin test. FV and V did not correlate with liver function tests. Post-operative complications were observed in 5 patients. The PRI of these patients was below 0.37. When PRI was above 0.38, no patient had hepatic failure. Conclusions: When PRI is above 0.38, there is a low probability of hepatic failure after hepatectomy. The PRI is useful in preoperative prediction of post-hepatectomy residual liver function in patients with liver disease.