Gon J, Nakagawa T, Tagami T, Maeda H, Kitano T, Sakuma H, Nakamura K
Department of Nuclear Medicine, China Medical University.
Kaku Igaku. 1991 Jan;28(1):1-10.
Intrahepatic shunt ratio was calculated from the fraction of the uptake constant and the blood background, analyzing the data of 99mTc-(Sn)-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) hepatobiliary imaging by Rutland method. Shunt flow and total hepatic blood flow (THBF) were also calculated from the values for the effective hepatic blood flow (EHBF) estimated from the blood clearance technique. In 15 cases of normal volunteer, the average of the shunt ratio, shunt flow, and THBF were 18.4 +/- 5.4 (S.D.)%, 137.8 +/- 49 ml/min, and 753 +/- 83.2 ml/min, respectively. In 8 cases of chronic hepatitis, the values were 35.2 +/- 2.6%, 276 +/- 55.4 ml/min, and 794.1 +/- 119.4 ml/min, respectively. In 12 cases of liver cirrhosis, the values were 51.4 +/- 12.6%, 353.9 +/- 141.3 ml/min, and 685.6 +/- 174.8 ml/min, respectively. In cases of chronic hepatitis and liver cirrhosis, in comparison with normal cases, the values for the shunt ratio and shunt flow were significantly increased (p less than 0.001) and those for EHBF were significantly decreased (p less than 0.001), but those for THBF were not significantly altered. There was a significant inverse correlation between the shunt ratio and EHBF (r = -0.842) in all 35 cases. This method is considered to be useful for differential diagnosis, estimation of the grade of the diseases, and evaluation of pathophysiology of various diffuse liver diseases.
采用Rutland法分析99mTc-（锡）-N-吡哆基-5-甲基色氨酸（99mTc-PMT）肝胆显像数据，根据摄取常数和血液本底的比例计算肝内分流率。还根据血液清除技术估算的有效肝血流量（EHBF）值计算分流流量和总肝血流量（THBF）。15例正常志愿者中，分流率、分流流量和THBF的平均值分别为18.4±5.4（标准差）%、137.8±49ml/min和753±83.2ml/min。8例慢性肝炎患者中，这些值分别为35.2±2.6%、276±55.4ml/min和794.1±119.4ml/min。12例肝硬化患者中，这些值分别为51.4±12.6%、353.9±141.3ml/min和685.6±174.8ml/min。在慢性肝炎和肝硬化病例中，与正常病例相比，分流率和分流流量值显著升高（p<0.001），EHBF值显著降低（p<0.001），但THBF值无显著变化。在所有35例病例中，分流率与EHBF之间存在显著的负相关（r=-0.842）。该方法被认为对各种弥漫性肝病的鉴别诊断、疾病分级评估和病理生理学评价有用。
