Shah A N, Dodson F, Fung J
Department of Radiology, University of Pittsburgh Medical Center, PA 15213, USA.
Semin Nucl Med. 1995 Jan;25(1):36-48. doi: 10.1016/s0001-2998(05)80005-4.
Orthotopic liver transplantation is now a very well-established technique for treating patients with end-stage liver disease. Since 1967, more than 26,000 liver transplants have been performed, including 15,000 in the United States. The overall 1-year survival rate is approximately 80% and 5-year survival is 70%. Nuclear imaging plays an important role in the management of liver transplant recipients before and after liver transplantation. The evaluation of candidates potentially includes liver-spleen scan for liver volume, multiple gated acquisition scan, adenosine or stress thallium study, bone scan, and quantitative ventilation perfusion scan for hepatopulmonary syndrome. In the post-transplant phase, the deconvolution analysis (which corrects for the problem of recirculation) is a promising tool for diagnosing rejection, although its role in the transplant population has to be established. A variety of nuclear medicine techniques are helpful in the postoperative diagnosis of biliary complications. By performing a semiquantitative analysis to discriminate hepatocyte dysfunction from biliary disease and measuring hepatocyte extraction fraction by deconvolution analysis and excretion, (T1/2 values measured by the nonlinear list squares technique) have been very promising.
原位肝移植如今是治疗终末期肝病患者的一项成熟技术。自1967年以来，已进行了超过26000例肝移植手术，其中美国有15000例。总体1年生存率约为80%，5年生存率为70%。核成像在肝移植受者肝移植前后的管理中发挥着重要作用。对候选者的评估可能包括用于测量肝脏体积的肝脾扫描、多门控采集扫描、腺苷或负荷铊显像、骨扫描以及用于诊断肝肺综合征的定量通气灌注扫描。在移植后阶段，去卷积分析（可校正再循环问题）是诊断排斥反应的一种有前景的工具，尽管其在移植人群中的作用还有待确定。多种核医学技术有助于术后胆道并发症的诊断。通过进行半定量分析以区分肝细胞功能障碍和胆道疾病，并通过去卷积分析和排泄测量肝细胞摄取分数，（通过非线性最小二乘法技术测量的T1/2值）已显示出很大的前景。
