Heterogeneous liver uptake of Tc-99m-GSA as quantified through SPECT/CT helps to evaluate the degree of liver fibrosis: A retrospective observational study.
Heterogeneous liver uptake of Tc-99m-GSA as quantified through SPECT/CT helps to evaluate the degree of liver fibrosis: A retrospective observational study.
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DOI：
10.1097/md.0000000000011765
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发表时间：
2018-08
期刊：
影响因子：
1.6
通讯作者：
Kawada N
中科院分区：
文献类型：
--
作者：
Kotani K;Kawabe J;Higashiyama S;Yoshida A;Kawamura E;Tamori A;Shiomi S;Kawada N
TC-99m-半乳糖基人血清白蛋白(GSA)显像用于评估肝脏储备功能，并可在单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)图像上直观地评估残余肝细胞的分布。肝脏摄取99m-GSA的异质性与肝纤维化之间的关系仍有待详细研究。我们分析了这种联系。51例慢性肝胆疾病患者行~(99m)Tm-GSA核素显像。受体(LHL15)和血液清除指数(HH15)(肝脏和心脏的摄取比率)从动态平面图像中获得。根据单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)图像计算肝脏摄取计数的最大值/平均值(Luc Max/Mean)，以此作为TC-99m-GSA肝脏摄取异质性的指标。我们评估了这些量化数值与肝纤维化之间的关系。Child-Pugh分级A级30例，B级16例，C级5例。在30例肝组织病理学可评估的患者中，晚期肝纤维化(F2-4)患者的LHL15低于轻度肝纤维化(F0-1)(中位数为0.90vs.0.92，P = .04)，而LUC MAX/Mean(中位数为1.80vs.1.70，P = .02)。多变量分析确定血小板(P = .04)和LUC最大值/平均值(P = .04)是晚期肝纤维化的促成因素。提示~(99)m-GSA SPECT/CT不仅可用于评价肝储备功能，还可用于评价肝纤维化程度。
Tc-99m-galactosyl human serum albumin (GSA) scintigraphy is used to assess the hepatic functional reserve, and allows for visual assessment of the residual hepatocyte distribution on single-photon emission computed tomography/computed tomography (SPECT/CT) images. The association between heterogeneous liver uptake of Tc-99m-GSA and liver fibrosis remains to be studied in detail. We analyzed this association. Fifty-one patients with chronic hepatobiliary disease undergoing a Tc-99m-GSA scintigraphy were included in this study. The receptor (LHL15) and blood clearance (HH15) indexes (the uptake ratios of the liver and heart) were obtained from dynamic planar images. The liver uptake count maximum-to-mean ratio (LUC Max/Mean) was calculated from single-photon emission computed tomography/computed tomography (SPECT/CT) images as an indicator of the Tc-99m-GSA liver uptake heterogeneity. We assessed the relationship between these quantified values and liver fibrosis. There were 30 Child-Pugh classification grade A patients, 16 grade B patients, and 5 grade C patients. Among the 30 patients whose liver histopathology was evaluable, those with advanced liver fibrosis (F2-4) had a lower LHL15 than those with mild liver fibrosis (F0-1) (median, 0.90 vs. 0.92, P = .04), and a higher LUC Max/Mean (median, 1.80 vs. 1.70, P = .02). The multivariate analysis identified platelets (P = .04) and the LUC Max/Mean (P = .04) as contributing factors of advanced liver fibrosis. These findings suggest that Tc-99m-GSA SPECT/CT can be used not only to assess the hepatic functional reserve, but also to evaluate a degree of liver fibrosis.