Juni J E, Reichle R
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.
Radiology. 1990 Oct;177(1):171-5. doi: 10.1148/radiology.177.1.2399315.
A direct, noninvasive technique was developed to quantitate hepatocyte function with computer assessment of scintiscans obtained after administration of technetium-99m disofenin in 53 patients with acute jaundice: 32 patients with normal livers, 10 patients with acute biliary obstruction, and 11 patients with acute hepatocellular dysfunction. In all patients a final clinical diagnosis was obtained with follow-up for a minimum of 4 months and, in most patients with obstruction or dysfunction, with surgery, intraoperative cholangiography, ultrasound, and/or computed tomography. Heart (blood pool) and liver time-activity curves were generated for 32 minutes after intravenous injection of 5-15 mCi (185-555 MBq) of Tc-99m disofenin and were subjected to deconvolutional analysis to determine the first-pass hepatocyte extraction fraction (HEF) of the tracer. The difference in HEF between patients with obstruction and those with dysfunction was highly significant (P = 3.3 X 10(-19)). Deconvolutional analysis eliminates the effects of tracer recirculation, thus permitting direct measurement of hepatic disofenin extraction, and appears to provide functional information useful in evaluation of the patient with acute jaundice.
开发了一种直接、无创的技术，通过对53例急性黄疸患者注射99m锝二乙三胺五醋酸后获得的闪烁扫描进行计算机评估，来定量肝细胞功能：32例肝脏正常患者、10例急性胆道梗阻患者和11例急性肝细胞功能障碍患者。所有患者均通过至少4个月的随访获得最终临床诊断，大多数梗阻或功能障碍患者通过手术、术中胆管造影、超声和/或计算机断层扫描获得诊断。静脉注射5 - 15 mCi（185 - 555 MBq）的99m锝二乙三胺五醋酸后32分钟生成心脏（血池）和肝脏时间-活性曲线，并进行去卷积分析以确定示踪剂的首过肝细胞提取分数（HEF）。梗阻患者和功能障碍患者之间的HEF差异非常显著（P = 3.3×10⁻¹⁹）。去卷积分析消除了示踪剂再循环的影响，从而可以直接测量肝脏对二乙三胺五醋酸的提取，并且似乎提供了有助于评估急性黄疸患者的功能信息。
