Studies of Hepatobiliary Scintigraphy and Functional Examination with 99mTc-HIDA

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We studied both morphologically and functionally the clinical application of 99mTc-HIDA in 130 patients with various hepatobiliary diseases. Highly resolved images were obtained from morphological diagnosis. However, in the patients with high bilirubin levels of over 4-6 mg/dl, liver uptakes of 99mTc-HIDA were disturbed. From the bileduct images, we could prove calculi or extension of the bileduct. We could also prove the abnormal localization or extension of the gallbladder, but failed to visualize gallstones as defective images. The diagnostic method of contractile function of the gallbladder was examined by comparison of the activities of the gallbladder before and after oral administration of yellow egg. In normal cases, the activity of the gallbladder was decreased to 5-30%. The liver uptake rate (Ku) and excretion rate (Ke) in the normal cases were 12.7%min and 1.89%min, respectively; hence, it was suggested that the metabolism of 99mTc-HIDA was turning over faster than that of 131I-BSP. Ku and Ke were low in the patients with hepatobiliary diseases. The correlation between Ku, total bilirubin level and ICG, and also that between Ke, total bilirubin level, γG TP and Al. Pase were recognized. In the normal cases, the blood concentration ratio 30 and 60 min to 5 min after injection were 27.7% and 16.1%, respectively, and higher values were obtained in the patients with liver functional diseases.
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