technetium-tc-99m-sulfur-colloid and Liver-Cirrhosis--Biliary

In regard to nuclear medicine literature reporting lung uptake of colloidal radiopharmaceuticals in patients with liver diseases, it has been hypothesized that liver abnormalities could trigger induction of pulmonary intravascular macrophages (PIMs) in humans normally lacking them. Recently, experimental induction of PIMs in rats in which they are not normally prevalent has been demonstrated to be at the origin of pulmonary hemodynamic alterations with an increased susceptibility to ARDS. If such induction may occur in humans, the risk of pulmonary hemodynamic alterations has to be considered and detected. This study demonstrates in a rodent model of biliary cirrhosis that scintigraphy of phagocytic function as commonly used for liver exploration is a suitable strategy for staging PIM development.. Sixty rats were randomized as follows: bile duct section (n = 40), sham operation (n = 10), and no operation (n = 10). The rats were submitted to scintigraphy of phagocytic function every 5 days over 35 days for the assessment of radiocolloid uptake within lung and liver. At day 35, radioactivity of blood was counted and immunohistochemistry was performed on lung specimens.. As disease progressed, radiopharmaceutical uptake decreased within the liver, while increasing considerably in the lung. At day 35, lung uptake averaged about 66% as compared to 3% before surgery. Lung histologic findings revealed numerous intravascular mononuclear cells closely related to the monocyte-macrophage lineage.. Scintigraphy of phagocytic function commonly used for liver scanning could be a suitable strategy for the diagnosis of the induction of PIMs under pathologic situations.

Topics: Animals; Disease Models, Animal; Disease Progression; Immunohistochemistry; Liver; Liver Cirrhosis, Biliary; Lung; Macrophages, Alveolar; Male; Phagocytosis; Radionuclide Imaging; Radiopharmaceuticals; Random Allocation; Rats; Rats, Wistar; Technetium Tc 99m Sulfur Colloid

Technetium-99m sulfur colloid scintigraphy was used to study alterations of reticuloendothelial function in 7 dogs with experimentally induced biliary cirrhosis and portosystemic shunting. Scintigraphic studies were performed before and 6 weeks after common bile duct ligation. Radiocolloid plasma clearance rate was determined by measuring activity in plasma samples and by analyzing the rate of liver uptake on dynamic scintigraphic image sequences. Percentage of uptake in the liver, spleen, and lungs, as well as the ratio of hepatic-to-extrahepatic uptake, was determined from static equilibrium images. Relative to preoperative values, there were significant decreases in plasma clearance rate, percentage of liver uptake, and ratio of hepatic-to-extrahepatic uptake and significant increases in percentage of spleen and lung uptake on postoperative studies. The mechanism of technetium-99m-labeled sulfur colloid extraction by the liver is different from that of other radiocolloids; it does not require active phagocytosis or pinocytosis. Thus, liver uptake of this tracer principally reflects effective liver blood flow. Portosystemic shunting was documented in these dogs at the time of the postoperative radiocolloid scans, and we believed was responsible for the decrease in liver reticuloendothelial activity. Possible mechanisms for the increased splenic and pulmonary reticuloendothelial activities are discussed.

Topics: Animals; Dogs; Liver Cirrhosis, Biliary; Mononuclear Phagocyte System; Portasystemic Shunt, Surgical; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Time Factors

A recurrent unilateral pleural effusion developed without obvious cause in two patients with cirrhosis of the liver. By the demonstration of the rapid passage of a radiolabelled colloid from abdomen to thorax, these effusions were proved to be secondary to clinically undetectable peritoneal effusions. A diaphragmatic tear, which had occurred during a previous splenectomy and which was apparent only at autopsy, was the cause of peritoneopleural communication in one patient. Previous surgery could also have been responsible for the pleural effusion in the other patient.

Topics: Child; Diaphragm; Female; Humans; Liver Cirrhosis; Liver Cirrhosis, Biliary; Middle Aged; Pleural Effusion; Postoperative Complications; Radionuclide Imaging; Recurrence; Splenectomy; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Liver blood flow was measured by dynamic 99Tcm-sulfur colloid accumulation and indocyanine green disappearance in 5 subjects, and by 99Tcm-sulfur colloid accumulation and 133Xe-wash-out in 7 subjects. Results obtained by the 99Tcm-sulfur colloid and indocyanine green methods were closely comparable, whereas the flow values estimated by the two isotope methods did not correlate well.

Topics: Adult; Aged; Fatty Liver; Female; Hepatitis; Humans; Indocyanine Green; Liver Circulation; Liver Cirrhosis, Biliary; Liver Diseases; Male; Methods; Middle Aged; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Xenon Radioisotopes