Ascher S A, Sarkar S D, Spivak W B
Department of Radiology, New York Hospital-Cornell Medical Center, New York 10021.
Clin Nucl Med. 1988 Jan;13(1):1-3. doi: 10.1097/00003072-198801000-00001.
The hepatic clearance of Tc-99m labeled iminodiacetic acid (IDA) compounds is believed to be impaired in patients with severe hyperbilirubinemia. Competitive inhibition of hepatocyte uptake of IDA by bilirubin has been demonstrated in vitro, but not by clinical scintigraphy. We present a patient with Crigler-Najjar syndrome without evidence of hepatobiliary damage, who demonstrated normal uptake and excretion of Tc-99m DISIDA despite a serum indirect bilirubin level in excess of 30 mg/dl. It is therefore suggested that a markedly elevated serum bilirubin level per se does not inhibit hepatic uptake of Tc-IDA and does not preclude clinically useful scintigraphic examination.
据信，患有严重高胆红素血症的患者，99m锝标记的亚氨基二乙酸（IDA）化合物的肝脏清除功能受损。胆红素对肝细胞摄取IDA的竞争性抑制作用已在体外得到证实，但临床闪烁扫描未显示此现象。我们报告了一名患有克里格勒-纳贾尔综合征且无肝胆损伤证据的患者，尽管其血清间接胆红素水平超过30mg/dl，但该患者对99m锝二异丙基乙酰胺（DISIDA）的摄取和排泄正常。因此，提示血清胆红素水平显著升高本身并不抑制肝脏对99m锝-IDA的摄取，也不排除进行有临床意义的闪烁扫描检查。
