technetium-tc-99m-lidofenin and Liver-Cirrhosis

Topics: Biliary Tract; Colloids; Gallbladder; Gallium Radioisotopes; Humans; Imino Acids; Iodine Radioisotopes; Liver; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Organotechnetium Compounds; Radionuclide Imaging; Rose Bengal; Sulfur; Technetium; Technetium Tc 99m Lidofenin; Technetium Tc 99m Sulfur Colloid

The function of polygonal liver cells can be estimated by using liver specific dyes such as labelled BSP or bengalrosa and labelled X-ray contrast media. Various methods are available: clearance with blood counting or external monitoring, whole body clearance and retention measurement. These tests are of value for following the course of liver diseases. Blood flow measurements either with labelled colloids or 133 Xe are mainly used for scientific purposes. Portosystemic shunts can be detected by injection of labelled microspheres in the spleen and lung monitoring or scanning. With the dynamic scintigraphy portosystemic shunts can be visualized ( radionuclide splenoportography). The measurement of the praecordial appearance time after rectal instillation of 133 Xe permits the functional evaluation of a surgical portosystemic shunt. Dynamic scintigraphy makes possible the estimation of the arterial part of liver blood flow after i.v. injection of 99m Tc and this together with the radionuclide splenoportography allows the assessment of disturbed blood flow in patients with portal hypertension. I. v. applied parathyroid hormone increases the arterial hepatic blood flow. Preliminary results indicate that patients with portal hypertension and a good response to parathyroid hormone seem to have a good prognosis after shunt operation. The determination of red cell survival with 51 Cr is helpful in the differential diagnosis of jaundice. The specificity of liver scanning with labelled colloids for malignant diseases can be reasonably increased by additional 67 Ga-scintigraphy. In the diagnosis of hepatoma with both colloid and Galliumscan and the evaluation of alpha-fetoprotein a 90% accuracy can be achieved. The hepatobiliary transport can easily be visualized with 99m Tc labelled IDA-compounds and also in patients with severe jaundice where the X-ray cholangiopathy is impossible. This examination is indicated in patients with bile duct observations (also intrahepatic), after cholecystectomy, for the differential diagnosis of jaundice, for the demonstration of refluxes etc. The most important radioimmunological in vitro methods for the investigation of liver diseases are only briefly described.

Topics: alpha-Fetoproteins; Bile Acids and Salts; Ferritins; Gallium Radioisotopes; Hepatic Artery; Hepatitis A; Hepatitis B; Humans; Imino Acids; Liver; Liver Circulation; Liver Cirrhosis; Liver Diseases; Liver Function Tests; Liver Neoplasms; Portasystemic Shunt, Surgical; Portography; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Xenon Radioisotopes

Scintigraphy with colloid 99mTc (56 cases) and the radiopharmaceutical preparation 99mTc--HIDA (43 cases) was performed in children with early and developed cirrhosis of the liver to study the functional condition of the hepatic Kupffer's and parenchymal cells in the long-term periods after surgical treatment. Increased activity of the parenchymal cells and inactivation of Kupffer's cells were revealed after splenectomy. The formation of a portocaval shunt and denervation of the hepatic artery promoted activation of hepatocyte functioning in these patients.

Topics: Child; Child, Preschool; Humans; Imino Acids; Liver Cirrhosis; Organotechnetium Compounds; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Bile duct ligated rats (n = 7) have been investigated for 6 months. Two patterns of evolution have been observed: (i) progressive development of cirrhosis and portosystemic shunt (detected by 201Tl per rectal scintigraphy) in three animals, (ii) repermeabilization of the biliary tract in four animals. Despite the small number of animals investigated, the 201Tl per rectal scintigraphy seems to be a good indicator of portosystemic shunt secondary to biliary cirrhosis.

Topics: Administration, Rectal; Animals; Cholestasis; Collateral Circulation; Disease Models, Animal; Imino Acids; Liver Cirrhosis; Organotechnetium Compounds; Portal Vein; Radionuclide Imaging; Rats; Rats, Inbred Strains; Technetium Tc 99m Lidofenin; Thallium; Thallium Radioisotopes; Venae Cavae

Topics: Adult; Aged; Antipyrine; Circadian Rhythm; Contrast Media; Fatty Liver; Humans; Imino Acids; Liver; Liver Cirrhosis; Male; Metabolic Clearance Rate; Middle Aged; Organotechnetium Compounds; Technetium Tc 99m Lidofenin

Fifty-two patients were studied with various diseases affecting liver parenchyma. Any disorders of bile transport were excluded on the basis of dynamic liver scintigraphy using intravenously injected N/2,4-dimethyl acetanilido/iminodiacetate 99mTc complex (HEPIDA). The activity concentration of 99mTc-HEPIDA in plasma was measured from 5 through 60 min post injection. Clearance of the substance (ClB) was calculated from blood plasma disappearance curves and compared with results of 13 laboratory tests used conventionally for assessment of damage of the liver and its functional capacity; age and body weight was also included in the analysis. Statistical relations were studied using linear regression analysis of two variables, multiple regression analysis as well as multidimensional analysis of variance. It was demonstrated that 99mTc-HEPIDA clearance is a simple, accurate and repeatable measure of liver parenchyma damage. In males, values of ClB above 245 ml. min-1/1.73 m2 exclude hepatic damage with high probability; values below 195 ml.min-1/1.73 m2 indicate evident impairment of liver parenchyma function.

Topics: Adolescent; Adult; Aged; Chemical and Drug Induced Liver Injury; Humans; Imino Acids; Liver Cirrhosis; Liver Diseases; Male; Middle Aged; Occupational Diseases; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin; Vinyl Chloride

99mTc-diethyl-HIDA cholescintigraphy was performed on 24 patients with histologically proven liver disease and on 10 normal adult subjects. Liver mass transport of HIDA was interpreted with the aid of a probabilistic model, assuming that the tracer particles undergo mixed random walks with drifts. The radiohepatograms were thus fitted with a gamma-variate function and the fitting parameters were evaluated as estimates of the severity of the disease. These parameters, together with the transit times, were also used to generate parametric images of liver function. The advantages of this approach are discussed and the following conclusions are drawn: (1) The gamma-fit is highly satisfactory with any type of experimental curve (0.98 less than r less than 1). (2) The parameters derived from the gamma-fit make it possible to objectively assess the extent of liver functional impairment. (3) Parametric imaging of the liver mass transport of HIDA is easily implemented, but still more experience is needed to assess its impact on patient care.

Topics: Bile Ducts; Cholestasis; Hepatitis; Humans; Imino Acids; Kinetics; Liver; Liver Cirrhosis; Liver Diseases; Models, Biological; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

Topics: Colloids; Humans; Imino Acids; Liver; Liver Cirrhosis; Male; Middle Aged; Mononuclear Phagocyte System; Organotechnetium Compounds; Phytic Acid; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin