Joshi S N, George E A, Perrillo R P
Gastroenterology. 1981 Dec;81(6):1045-51.
Excretory liver function was analyzed in 10 healthy volunteers and 28 subjects with acute or chronic liver injury following intravenous administration of 99mtechnetium p-isopropyl iminodiacetic acid. Hepatobiliary transit of this agent was quantitated at 5-min intervals for a total of 60 min. Indices of total liver activity, liver cell uptake, liver parenchymal clearance, and bile duct clearance of 99mtechnetium p-isopropyl iminodiacetic acid were calculated from time--activity curves over heart, liver, extrahepatic bile ducts, and gallbladder. Seven subjects with acute viral hepatitis, 15 with extrahepatic biliary obstruction, and 6 with intrahepatic cholestasis were evaluated. Compared with healthy volunteers, a significant (p less than 0.0001) reduction in total liver activity and liver parenchymal clearance was demonstrated in all patient groups. Major resolution in all liver-derived indices, particularly total liver activity, occurred during convalescence from hepatitis and after biliary drainage. Nonmeasurable bile duct clearance always indicated a diagnosis of extrahepatic obstruction in cholestatic subjects, and this index normalized in subjects following biliary drainage. Whereas visual assessment of 99mtechnetium p-isopropyl iminodiacetic acid scans provided limited, useful information about the functional status of the liver, quantitative temporal analysis proved to be a much more effective technique.
在10名健康志愿者和28名急性或慢性肝损伤患者静脉注射99m锝-对异丙基亚氨基二乙酸后，分析其肝脏排泄功能。每隔5分钟对该药物的肝胆转运进行定量，共持续60分钟。根据心脏、肝脏、肝外胆管和胆囊的时间-活性曲线计算99m锝-对异丙基亚氨基二乙酸的总肝脏活性、肝细胞摄取、肝实质清除和胆管清除指数。对7名急性病毒性肝炎患者、15名肝外胆管梗阻患者和6名肝内胆汁淤积患者进行了评估。与健康志愿者相比，所有患者组的总肝脏活性和肝实质清除均显著降低（p<0.0001）。在肝炎恢复期和胆管引流后，所有肝脏衍生指标，尤其是总肝脏活性，有明显改善。无法测量的胆管清除率总是提示胆汁淤积患者存在肝外梗阻，该指标在胆管引流后的患者中恢复正常。虽然对99m锝-对异丙基亚氨基二乙酸扫描的视觉评估为肝脏功能状态提供了有限但有用的信息，但定量时间分析被证明是一种更有效的技术。
