Kuni C C, Engeler C M, Nakhleh R E, duCret R P, Boudreau R J
Department of Radiology, University of Minnesota Hospital and Clinics, Minneapolis.
J Nucl Med. 1991 Aug;32(8):1545-7.
We compared 76 99mTc-DISIDA hepatobiliary studies with corresponding liver biopsies in 36 liver transplant patients to determine the histopathologic abnormalities that corresponded to scintigraphic abnormalities in uptake and excretion. Uptake was judged normal if the cardiac blood pool was barely visible or invisible on the ten minute image. Excretion was judged normal if images subsequent to the 15-min image showed a subjectively normal rate of decreasing parenchymal intensity. Biopsies were graded subjectively for hepatocyte damage and for findings of cholestasis. Uptake criteria were successful in differentiating high from low hepatocyte damage scores (p less than 0.0001), and excretion criteria were successful in differentiating high from low cholestasis scores (p = 0.002), while uptake criteria were not capable of differentiating high from low cholestasis scores, nor were excretion criteria capable of differentiating high from low hepatocyte damage scores (p's greater than 0.05). These results suggest that scintigraphy can distinguish intrahepatic cholestasis from pure hepatocyte damage.
我们将76例肝移植患者的99mTc - DISIDA肝胆显像研究结果与相应的肝活检结果进行了比较，以确定与摄取和排泄方面的闪烁显像异常相对应的组织病理学异常。如果在10分钟图像上心腔血池几乎不可见或不可见，则判定摄取正常。如果15分钟图像后的图像显示实质强度主观上以正常速率下降，则判定排泄正常。对活检标本的肝细胞损伤和胆汁淤积情况进行主观分级。摄取标准成功区分了高肝细胞损伤评分和低肝细胞损伤评分（p < 0.0001），排泄标准成功区分了高胆汁淤积评分和低胆汁淤积评分（p = 0.002），而摄取标准无法区分高胆汁淤积评分和低胆汁淤积评分，排泄标准也无法区分高肝细胞损伤评分和低肝细胞损伤评分（p > 0.05）。这些结果表明，闪烁显像可区分肝内胆汁淤积和单纯肝细胞损伤。
