Clinical usefulness of scintigraphy with 99mTc-galactosyl-human serum albumin for prognosis of cirrhosis of the liver.
Clinical usefulness of scintigraphy with 99mTc-galactosyl-human serum albumin for prognosis of cirrhosis of the liver.
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99mTc-半乳糖基-人血清白蛋白闪烁扫描对肝硬化预后的临床用途。
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发表时间：
1999
期刊：
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通讯作者：
H. Ochi
中科院分区：
文献类型：
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作者：
N. Sasaki;S. Shiomi;Y. Iwata;S. Nishiguchi;T. Kuroki;J. Kawabe;H. Ochi
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~(99m)Tc-二乙三胺五乙酸-半乳糖-人血清白蛋白(99mTC-GSA)显像可用于评价肝脏储备功能。我们评估了这项技术的临床实用性，包括它在确定肝硬变患者预后方面的价值。
方法
对10例健康人、42例慢性肝炎和158例肝硬变患者进行了99mTC-GSA核素显像。计算机采集伽马相机数据是在注射99mTC-GSA之前开始的。心脏和肝脏的时间-活动曲线是根据心脏和整个肝脏的感兴趣区(ROI)生成的。注射15分钟后，用肝脏ROI的放射性除以肝脏和心脏ROI的放射性计算受体指数。用15min时心脏ROI的放射性除以3min时心脏ROI的放射性来计算血液清除指数。
结果
肝硬变患者的中位受体指数低于慢性肝炎患者和健康人，而血清白蛋白的中位指数高于慢性肝炎患者和正常人。当出现并发症(静脉曲张、腹水)时，受体指数显著降低。当出现并发症(静脉曲张和腹水)时，血液清除指数明显较高。两项指标与功能储备经典指标的相关性显著。根据受体指数将患者分为两组，A组受体指数大于0.85，B组受体指数小于或等于0.85。根据血清除指数将肝硬变患者分为两组，A组血清除指数0.70，B组血清除指数OR=0.70。B组累积存活率低于A组。
结论
99mTC-GSA核素显像在临床上有一定的应用价值，特别是对判断肝硬变患者的预后有重要意义。
UNLABELLED
Scintigraphy with 99mTc-diethylenetriamine pentaacetic acid-galactosyl-human serum albumin (99mTc-GSA) is useful for evaluating hepatic functional reserve. We assessed the clinical usefulness of this technique, including its value in establishing a prognosis, in patients with cirrhosis of the liver.
METHODS
Scintigraphy with 99mTc-GSA was performed in 10 healthy subjects, 42 patients with chronic hepatitis and 158 patients with cirrhosis. Computer acquisition of gamma camera data were started just before the injection of 99mTc-GSA. Time-activity curves for the heart and liver were generated from regions of interest (ROIs) for the heart and the entire liver. A receptor index was calculated by dividing the radioactivity of the liver ROI by that of the liver-plus-heart ROI 15 min after the injection. An index of blood clearance was calculated by dividing the radioactivity of the heart ROI at 15 min by that of the heart ROI at 3 min.
RESULTS
The median receptor index was lower in patients with cirrhosis than in patients with chronic hepatitis or in healthy subjects, and the median index of blood clearance was higher. The receptor index was significantly lower when a complication (varices, ascites) was present. The index of blood clearance was significantly higher when a complication (varices and ascites) was present. Correlation of the two indices with classic indicators for functional reserve was significant. On the basis of the receptor index, the patients with cirrhosis were divided into two groups of roughly equal size: group A, receptor index over 0.85, and group B, receptor index 0.85 or less. On the basis of the index of blood clearance, the patients with cirrhosis were divided into two groups of roughly equal size: group A, index of blood clearance < 0.70, and group B, index of blood clearance > or = 0.70. The cumulative survival rates were lower in group B than in group A.
CONCLUSION
Scintigraphy with 99mTc-GSA is clinically useful, especially in establishing the prognosis of patients with cirrhosis of the liver.