Stadalnik R C, Vera D R, Woodle E S, Trudeau W L, Porter B A, Ward R E, Krohn K A, O'Grady L F
J Nucl Med. 1985 Nov;26(11):1233-42.
Technetium-99m galactosyl-neoglycoalbumin ( [Tc]NGA) is a radiolabeled ligand to hepatic binding protein, a receptor which resides at the plasma membrane of hepatocytes. This receptor-binding radiopharmaceutical and its kinetic model provide a noninvasive method for the assessment of liver function. Eighteen patients were studied: seven with hepatoma, eight with liver metastases, four with cirrhosis (two had concurrent hepatoma and one chronic active hepatitis), and one patient with acute fulminant non-A, non-B hepatitis. Technetium-99m NGA liver imaging provided anatomic information of diagnostic quality comparable to that obtained with other routine imaging modalities, including computed tomography, angiography, ultrasound, and [Tc]sulfur colloid scintigraphy. Kinetic modeling of dynamic [Tc]NGA data produced estimates of standardized hepatic blood flow, Q (hepatic blood flow divided by total blood volume), and hepatic binding protein concentration, [HBP]. Clinical correlation was by classical Child-Turcotte criteria (CTC). Significant rank correlation was obtained between [HBP] estimates and CTC scores (rs = -0.72, p = 0.001). This correlation supports the hypothesis that [HBP] is a measure of functional hepatocyte mass. The combination of decreased Q and markedly reduced [HBP] may have prognostic significance; all three patients with this combination died of hepatic failure within 6 wk of imaging.
锝-99m半乳糖基-新糖白蛋白（[Tc]NGA）是一种与肝结合蛋白结合的放射性标记配体，肝结合蛋白是一种存在于肝细胞质膜上的受体。这种受体结合放射性药物及其动力学模型为评估肝功能提供了一种非侵入性方法。对18例患者进行了研究：7例患有肝癌，8例患有肝转移瘤，4例患有肝硬化（2例同时患有肝癌，1例患有慢性活动性肝炎），1例患有急性暴发性非甲非乙型肝炎。锝-99m NGA肝脏显像提供的诊断质量解剖学信息与其他常规显像方式（包括计算机断层扫描、血管造影、超声和[Tc]硫胶体闪烁显像）所获得的信息相当。动态[Tc]NGA数据的动力学建模得出了标准化肝血流量（Q，肝血流量除以总血容量）和肝结合蛋白浓度[HBP]的估计值。临床相关性采用经典的Child-Turcotte标准（CTC）。[HBP]估计值与CTC评分之间存在显著的等级相关性（rs = -0.72，p = 0.001）。这种相关性支持了[HBP]是功能性肝细胞质量指标的假设。Q降低和[HBP]显著降低的组合可能具有预后意义；所有具有这种组合的3例患者在显像后6周内死于肝衰竭。
