Kotani Kohei, Kawabe Joji, Higashiyama Shigeaki, Shiomi Susumu
Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
World J Nucl Med. 2017 Oct-Dec;16(4):320-323. doi: 10.4103/1450-1147.215493.
We report a 56-year-old woman with regional liver disorder due to acute hepatitis. Computed tomographic images showed low signal density at a plain phase and prolonged contrast effect at a late phase in the left hepatic lobe, in which an accumulation of Tc-phytate increased, whereas that of Tc-galactosyl human serum albumin (GSA) decreased. Meanwhile, in the right lobe, an accumulation of Tc-GSA showed more increased than that of Tc-phytate. Liver biopsy showed massive hepatocyte necrosis and interface hepatitis in the left lobe, and moderate hepatitis in the right lobe. Differences in the accumulation between these scintigrams were helpful for understanding rapid necrosis in the left lobe, resulting in a compensatory enlargement of the right lobe. Clinicians should be aware that some cases of acute hepatitis cause regional liver disorder although most cases show homogeneous inflammation.
我们报告了一名56岁因急性肝炎导致区域性肝脏疾病的女性。计算机断层扫描图像显示，肝左叶在平扫期呈低信号密度，延迟期有延长的对比增强效应，其中锝-植酸盐积聚增加，而锝-半乳糖基人血清白蛋白（GSA）积聚减少。同时，在肝右叶，锝-GSA的积聚比锝-植酸盐增加得更多。肝脏活检显示肝左叶有大量肝细胞坏死和界面性肝炎，肝右叶有中度肝炎。这些闪烁扫描图中积聚情况的差异有助于理解肝左叶的快速坏死，导致肝右叶代偿性增大。临床医生应意识到，尽管大多数急性肝炎病例表现为均匀性炎症，但有些病例会导致区域性肝脏疾病。
