Erdogan Deha, Heijnen Bob H M, Bennink Roelof J, Kok Mariël, Dinant Sander, Straatsburg Irene H, Gouma Dirk J, van Gulik Thomas M
Department of Surgery, Academic Medical Center, University of Amsterdam, The Netherlands.
Liver Int. 2004 Apr;24(2):117-23. doi: 10.1111/j.1478-3231.2004.00901.x.
BACKGROUND/AIMS: The indocyanine green (ICG) clearance test is the most frequently used test for preoperative assessment of liver parenchymal function but has its limitations. The aim of this study was to investigate the correlation between ICG clearance test and the liver uptake of 99-Technetium-labelled (99mTc)-Mebrofenin (99mTc-Mebrofenin) as measured with hepatobiliary scintigraphy.
Fifty-four patients were diagnosed as hepatocellular carcinoma (n=9), hilar tumours (n=20) and 25 patients with non-parenchymal tumours including colorectal metastasis (n=15) and miscellaneous tumours (n=10). One day prior to operation, hepatobiliary 99mTc-Mebrofenin scintigraphy was performed after intravenous injection of 85 MBq and the 15-min clearance rate of ICG (ICG-C15) was measured.
The mean ICG-C15 was 86.86+/-1.19% (SEM). The mean 99mTc-Mebrofenin uptake rate was 12.87+/-0.52%/min. A significant correlation was obtained between 99mTc-Mebrofenin uptake rate by scintigraphy and ICG-C15 (r=0.73, P<0.0001). The mean clearance capacity of the right liver segments (79.83+/-1.63, range 47.75-95.97%) was larger than that of the left segments (20.24+/-1.55, range 6.51-52.51%).
99mTc-Mebrofenin uptake rate as assessed by scintigraphy is an efficient method for determining liver function and correlates well with ICG clearance. At the same time, 99mTc-Mebrofenin scintigraphy provides information of segmental functional liver tissue, which is of additional use when planning liver resection.
背景/目的：吲哚菁绿（ICG）清除试验是术前评估肝实质功能最常用的检查，但存在局限性。本研究旨在探讨ICG清除试验与通过肝胆闪烁显像测量的99-锝标记（99mTc）-美罗芬宁（99mTc-美罗芬宁）肝脏摄取之间的相关性。
54例患者被诊断为肝细胞癌（n=9）、肝门部肿瘤（n=20）以及25例非实质肿瘤患者，包括结直肠转移瘤（n=15）和其他肿瘤（n=10）。术前一天，静脉注射85MBq后进行肝胆99mTc-美罗芬宁闪烁显像，并测量ICG的15分钟清除率（ICG-C15）。
ICG-C15的平均值为86.86±1.19%（标准误）。99mTc-美罗芬宁摄取率的平均值为12.87±0.52%/分钟。闪烁显像测得的99mTc-美罗芬宁摄取率与ICG-C15之间存在显著相关性（r=0.73，P<0.0001）。右肝段的平均清除能力（79.83±1.63，范围47.75-95.97%）大于左肝段（20.24±1.55，范围6.51-52.51%）。
闪烁显像评估的99mTc-美罗芬宁摄取率是一种有效的肝功能测定方法，与ICG清除率具有良好的相关性。同时，99mTc-美罗芬宁闪烁显像可提供肝段功能肝组织的信息，在规划肝切除时具有额外的用途。
