Keeffe E B, Lieberman D A, Krishnamurthy S, Krishnamurthy G T, Gilbert S A
Department of Medicine and Clinical Pathology, Oregon Health Sciences University, Portland 97201.
Radiology. 1988 Jan;166(1 Pt 1):143-8. doi: 10.1148/radiology.166.1.3257301.
The authors studied ten patients with primary biliary cirrhosis using planar and single photon emission computed tomography (SPECT); results were compared with those from 13 healthy subjects. Patients with primary biliary cirrhosis had six- to tenfold prolongation of mean halflife (t 1/2) hepatic excretion of technetium-99m iminodiacetic acid (IDA) compared with mean t 1/2 excretion in healthy subjects. All patients with primary biliary cirrhosis had diffuse, uniform hepatic isotope retention and normal major bile ducts on planar and SPECT scans. The gallbladder was seen within 60 minutes in nine of nine patients who had intact gallbladders. The mean gallbladder volume was normal, but gallbladder ejection fractions and ejection rates were reduced in patients with primary biliary cirrhosis compared with those of healthy subjects. In contrast with previous studies of patients with sclerosing cholangitis and common bile duct obstruction, patients with primary biliary cirrhosis had different findings on scintiscans. In the early evaluation of patients with cholestasis, Tc-99m IDA hepatobiliary scintigraphy may be useful in the selection of the most appropriate invasive diagnostic test to enable a definitive diagnosis.
作者使用平面显像和单光子发射计算机断层扫描（SPECT）对10例原发性胆汁性肝硬化患者进行了研究；并将结果与13名健康受试者的结果进行了比较。与健康受试者的平均半衰期（t1/2）排泄相比，原发性胆汁性肝硬化患者的锝-99m亚氨基二乙酸（IDA）肝脏排泄的平均半衰期延长了6至10倍。所有原发性胆汁性肝硬化患者在平面显像和SPECT扫描中均有弥漫性、均匀性肝脏同位素滞留且主要胆管正常。9例胆囊完整的患者中有9例在60分钟内可见胆囊。平均胆囊体积正常，但与健康受试者相比，原发性胆汁性肝硬化患者的胆囊排空分数和排空率降低。与之前对硬化性胆管炎和胆总管梗阻患者的研究不同，原发性胆汁性肝硬化患者在闪烁扫描中有不同的表现。在胆汁淤积患者的早期评估中，锝-99m IDA肝胆闪烁显像可能有助于选择最合适的侵入性诊断检查以做出明确诊断。
