Analysis of hepatic hemodynamics by new method of per-rectal portal scintigraphy using 99mTcO4- (direct intramural administration of radioisotope method).

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To depict of porto-systemic collaterals clearly, and to analyze of hemodynamics of liver, we developed new method of per-rectal portal scintigraphy (direct intramural administration of 99mTcO-4 by 23G needle). And we used this method in patient with liver diseases (acute hepatitis: 5, chronic hepatitis: 7, liver cirrhosis: 25 cases). From time activity curve of the liver and the heart, liver/heart ratio; index of porto-systemic shunt via inferior mesenteric vein (IMV) and first flow ratio(k); index of portal blood flow from IMV pathway/index of hepatic total blood flow were calculated.In our method, the images of portal vein, liver, heart, especially porto-systemic collaterals were visualized more clearly than enema methods. The liver/heart ratio was significantly lower in patients with liver cirrhosis than that in non-cirrhotic patients (p<0.01), which indicated that patients with liver cirrhosis had more porto-systemic collaterals than non-cirrhotic diseases. The k was more lower in liver cirrhosis than in acute hepatitis (p<0.01). And the k was also more lower in chronic hepatitis than in acute hepatitis (p<0.1), which indicated that portal blood flow via IMV reduced in early stage of chronic liver diseases.In conclusion, new method of per-rectal portal scintigraphy has more advantage for analysis of hepatic hemodynamics than enema methods.
財団法人日本消化器病学会の論文