Xiang Can-hong, Chen Ying-mao, Shao Ming-zhe, Li Can, Liu Han-sheng, Zhang Jin-ming, Liu Zhi-wei, Duan Wei-dong, Cai Shou-wang, Tian Jia-he, Dong Jia-hong
Department of Hospital & Institute of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Zhonghua Wai Ke Za Zhi. 2013 Jul;51(7):592-5.
To evaluate the effectiveness of dynamic SPECT (99m)Tc-galactosyl human serum albumin (GSA) scintigraphy on the assessment of reserve function of cirrhosis liver.
From January 2010 to December 2011, 55 patients with cirrhosis liver were enrolled in this study. The case numbers of male and female were 43 and 12 respectively and the age was (51 ± 9) years (ranging from 35 to 69 years). After routine biochemistry test, CT scan and (99m)Tc-GSA dynamic SPECT scan were performed in turn using a juxtaposed SPECT/CT system. Then the morphologic volume of liver parenchyma (MLV), functional liver volume (FLV) and the hepatic cell absorption rate constant (GSA-K) were calculated. The correlations between GSA-K and routine biochemistry test, Child-Pugh score, indocyanine green clearance rate (ICG-K) were analyzed. The patients were further divided into 3 groups according to whether there was occlusion or stenosis in the main branch of left portal vein (group 1, n = 5), right portal vein (group 2, n = 13) or not (group 3, n = 37) and the regional hepatic functions index of the 3 groups were compared.
The value of FLV of the whole, left and right liver was (594 ± 152) ml, (244 ± 119) ml and (356 ± 171) ml, respectively. There were correlations between GSA-K and total bilirubin, prothrombintime, Child-Pugh score and ICG-K (r = -0.730--0.298, P < 0.05). The FLV and MLV ratios of involved hemiliver to uninvolved hemiliver were 0.09 ± 0.06 and 0.30 ± 0.14 in group 1, 0.57 ± 0.43 and 1.08 ± 0.63 in group 2, 0.71 ± 0.30 and 0.71 ± 0.48 in group 3. The difference in MLV-FLV ratio was signifcant between group 1 and group 3, between group 2 and group 3 (P = 0.000).
The dynamic SPCECT (99m)Tc-GSA scintigraphy can not only assess the whole liver function of cirrhosis liver effectively, but also evaluate the variation of regional liver function accurately.
评估动态单光子发射计算机断层扫描（SPECT）99m锝-半乳糖基人血清白蛋白（GSA）闪烁扫描术在评估肝硬化肝脏储备功能方面的有效性。
2010年1月至2011年12月，55例肝硬化患者纳入本研究。男性43例，女性12例，年龄（51±9）岁（35至69岁）。依次进行常规生化检查、CT扫描及99m锝-GSA动态SPECT扫描，采用并列式SPECT/CT系统。然后计算肝实质形态学体积（MLV）、功能性肝体积（FLV）及肝细胞摄取率常数（GSA-K）。分析GSA-K与常规生化检查、Child-Pugh评分、吲哚菁绿清除率（ICG-K）之间的相关性。根据左门静脉主干（第1组，n = 5）、右门静脉主干（第2组，n = 13）有无阻塞或狭窄将患者进一步分为3组（第3组，n = 37），比较3组的区域肝功能指标。
全肝、左肝和右肝的FLV值分别为（594±152）ml、（244±119）ml和（356±171）ml。GSA-K与总胆红素、凝血酶原时间、Child-Pugh评分及ICG-K之间存在相关性（r = -0.730至-0.298，P < 0.05）。第1组患侧半肝与健侧半肝的FLV和MLV比值分别为0.09±0.06和0.30±0.14，第2组为0.57±0.43和1.08±0.63，第3组为0.71±0.30和0.71±0.48。第1组与第3组、第2组与第3组之间的MLV-FLV比值差异有统计学意义（P = 0.000）。
动态SPECT 99m锝-GSA闪烁扫描术不仅能有效评估肝硬化肝脏的整体肝功能，还能准确评估区域肝功能的变化。
