Woodle E S, Ward R E, Stadalnik R C, Vera D R
Department of Surgery, University of California, Davis Medical Center, Sacramento 95817.
Surgery. 1989 Mar;105(3):401-7.
Technetium-99m galactosyl-neoglycoalbumin (Tc-NGA) is a new liver imaging agent that binds to hepatic-binding protein, a hepatocyte-specific membrane receptor. The purpose of this study was to determine the potential of Tc-NGA imaging in clinical liver transplantation. A total of 25 studies were performed in nine patients. Imaging studies performed in the early posttransplant period in patients with good hepatic allograft function revealed diffuse patchiness in tracer distribution, a manifestation of preservation damage. Left lobar infarction was demonstrated within a few hours of ischemic injury. Right posterior segmental infarction was seen in another patient. Comparison of kinetic, clinical, and biochemical data revealed good correlation between hepatic allograft function and Tc-NGA kinetics. Major kinetic alterations were noted during periods of preservation injury, hepatic infarction, and acute rejection. These studies indicate: (1) major alterations in Tc-NGA kinetics occur during preservation injury, hepatic infarction, and acute rejection, and (2) Tc-NGA kinetic data appear to provide an accurate reflection of hepatic allograft function. Tc-NGA imaging has the advantages of being noninvasive and of utilizing standard nuclear medicine instrumentation, including portable imaging devices. In conclusion, Tc-NGA imaging provides a promising noninvasive approach for evaluation of liver function in patients undergoing hepatic transplantation.
锝-99m半乳糖基-新糖白蛋白（Tc-NGA）是一种新型肝脏显像剂，它能与肝结合蛋白（一种肝细胞特异性膜受体）相结合。本研究的目的是确定Tc-NGA显像在临床肝移植中的应用潜力。对9例患者共进行了25项研究。对移植后早期肝功能良好的患者进行的显像研究显示，示踪剂分布呈弥漫性斑片状，这是保存损伤的表现。缺血损伤后数小时内发现左叶梗死。另一例患者可见右后段梗死。动力学、临床和生化数据的比较显示，肝移植功能与Tc-NGA动力学之间具有良好的相关性。在保存损伤、肝梗死和急性排斥反应期间，观察到主要的动力学改变。这些研究表明：（1）在保存损伤、肝梗死和急性排斥反应期间，Tc-NGA动力学发生重大改变；（2）Tc-NGA动力学数据似乎能准确反映肝移植功能。Tc-NGA显像具有无创性以及可使用包括便携式成像设备在内的标准核医学仪器的优点。总之，Tc-NGA显像为评估肝移植患者的肝功能提供了一种很有前景的无创方法。
