Ha-Kawa S K, Suga Y, Ikeda K, Nagata K, Murata T, Tanaka Y
Department of Radiology, Kansai Medical University, Osaka.
Kaku Igaku. 1993 Nov;30(11):1333-9.
The authors introduced blood disappearance corrected hepatic uptake ratio (LHL/HH) as an index of hepatic function using 185 MBq/3 mg of 99mTc-galactosyl serum albumin (GSA). Three ratio parameters, the hepatic uptake ratio (LHL15), blood disappearance ratio (HH15), and LHL15 divided by HH15 (LHL/HH) were evaluated with percent injected dose of 99mTc-GSA in blood at 15 min after injection (%ID15) and hepatic functional severity graded by Child-Turcotte criteria score. Seventy eight patients with chronic liver disease were studied. There was a poor linear correlation between the LHL15 and %ID15, because the LHL15 formed a plateau phase in the lower-value range for %ID15. In contrast, LHL/HH showed an excellent linear correlation with %ID15 in its whole range. In the comparison with the clinical functional severity, LHL/HH gave a more highly significant difference (p < 0.001) than LHL15 (p = 0.005) between the normal and mild dysfunction groups and gave a significant difference (p = 0.032) between the mild and moderate groups, in which HH15 showed no meaningful difference (p = 0.07). This index is obtained with no difficult procedures and can be regarded as a unified parameter for hepatic uptake and blood disappearance. It is hoped that LHL/HH will prove useful in the diagnosis of hepatic functional severity using 99mTc-GSA.