Per-rectal portal scintigraphy for the evaluation of portal circulation in patients with primary biliary cirrhosis.

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Portal circulation in patients with chronic liver diseases was evaluated by a new method named per-rectal portal scintigraphy. Following instillation of a solution containing 10mCi of 99mTcO-4 into the upper part of the rectum, serial scintigrams were taken sequentially. At the same time, the radioactivity curves over the liver and the heart were recorded sequentially. Per-rectal portal shunt indices were calculated from serial radioactivities on the liver and the heart. 1) Per-rectal portal shunt indices (SI) were ranged from 1.9% to 5.2% (mean 4.1%) in the healthy subjects. In patients with hepatitis the mean SI was 6.9%, in patients with cirrhosis it was 52.9%, in patients with PBC it was 46.8% and in patients with IPH it was 54.4%. 2) The SI was higher in cirrhotic patients with esophageal varices than in those without (p<0.001). The SI was higher in cirrhotic patients with encephalopathy than in those without (p<0.01). 3) A good correlation (r=0.774) was obtained between SI and ICGR-15. But in the patients with PBC and IPH, ICGR-15 was lower than that of the patients with chronic liver diseases who show same SI as the patients with PBC and IPH. A good correlation (r=-0.716) was obtained between SI and cholinesterase. But in the patients with PBC and IPH, cholinesterase was lower than that of the patients with chronic liver diseases who show same SI as the patients with PBC and IPH.
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