Japanese
Title肝・胆道シンチグラフィーの画像情報からみた疾患別検討
Subtitle原著
Authors伊藤和夫*, 南須原浩一**, 小柴隆蔵***, 斎藤知舘子***, 古舘正従*
Authors(kana)
Organization*北海道大学医学部放射線科, **砂川市立病院内科, ***市立札幌病院放射線科
Journal核医学
Volume16
Number8
Page1379-1394
Year/Month1979/11
Article原著
Publisher日本核医学会
Abstract「要旨」99mTc-HIDA肝・胆道スキャン205症例, 215回について, 画像情報(スキャン所見)からみた疾患別検討を行なった. (1)215例中, 肝実質の描出, 胆管描出, 消化管描出の所見から診断不能と判断された例は18例(8%)であった. (2)診断不能例の血清ビリルビン値は5mg/dl以下の例も含まれていた. (3)胆嚢描出を4型に分類(prompt, delayed, mal-position/mal-contour, double/superimposed)し, 疾患別分布を検討した. 非疾患群は, prompt filling示をした. しかし, prompt fillingは, び漫性肝疾患群にもみられ, 鑑別的意義に乏しかった. delayed fillingは, 胆石症とび漫性肝疾患群にみられた. double/super imposed fillingはcholedocal cystに特徴的所見であった. (4)胆嚢非描出例は, 胆嚢疾患と総胆管結石症に多く見られた. しかし, 胆石の存在は胆嚢非描出とは無関係であった. (5)胆管拡張の所見は, 胆管内RI通過よりtrue dilatationとfalse dilatationに区別することが妥当であった. (6)肝実質内RI転送の延長は, 肝内胆汁うっ滞の所見が示唆された. (7)99mTc-HIDAの胆汁通過の所見は, 胆道形成術などの術後の経過観察に適していた.
Practice臨床医学：一般
Keywords99mTc-HIDA, Hepatobiliary, Scintigraphy
English
TitleAnalysis of Hepatobiliary Scintigraphy with 99mTc-HIDA in Verious Diseases
SubtitleOriginal Articles
AuthorsKazuo ITOH*, Koichi NASUHARA**, Ryuzo KOSHIBA***, Chihoko SAITO***, Masayori FURUDATE*
Authors(kana)
Organization*Department of Radiology, School of Medicine, Hokkaido University, **Department of Internal Medicine, Sunagawa's City Hospital, ***Department of Radiology, City Hospital of Sapporo
JournalThe Japanese Journal of nuclear medicine
Volume16
Number8
Page1379-1394
Year/Month1979/11
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] 215 scans with 99mTC-HIDA in 205 cases performed were reviewed for evaluation of diagnostic application to hepatobiliary diseases. 1) There are 18 scans (%) of 215 studies appreciated of non-diagnotic. Serum bilirubin level in those cases was of 7.6 mg/dl to 25.1mg/dl in three of non-obstructive jaundice, 3.2 mg/dl to 19.2 mg/dl in eighteen of obstructive jaundice, respectively. 2) A filling of the gallbladder in 120 scans (69%) is classified to four patterns of "prompt", "delayed", mal-position and/or mal-contour" and "double and/or superimposed". A prompt filling was seen in 29 scnas of normal case, 9 ones of diseases of biliary trees, 27 ones of parenchymal hepatic diseases, respectively. A delayed filling was revealed in 4 scans of diseases of biliary tree systems and 7 ones of diffuse hepatic parenchymal disease. This finding is suggestive of the presence of above chronicity, except 3 scans not yet diagnosed. A filling of the gallbladder as a mal-position and/or mal-contour was of no specific value. However, this finding was useful evaluation of intrahepatic pathological areas of decreased radioactivity referred to colloidal liver scan. Every double and/or superimposed filling was corresponding to five choledocal cysts. This finding is of the most specific value in classification of the gallbladder filling. Dubin-Johnson's syndrome shows delayed filling of the gallbladder at 2 hours after the injection as well as persisted visualization of the hepatic parenchyma, seemingly due to prolonged intrahepatic transit of radiotracer. 3) No visualization of the gallbladder were seen in 2 scans of nonfasted cases, 39 scans of diseases of biliary tree systems, 2 ones of diffuse hepatic disease, 26 ones of the postsurgery and 7 ones not yet diagnosed. No filling of the gallbladder was also seen in 18 scans (62%) of 29 patients with cholecystitis with or without cholelithiasis. In an active phase of cholecystitis, the gallbladder did not concentrates 99mTc-HIDA, even though intravenous choleangiogram showed an oppacification of the gallbladder. These cases were included of three. Dilatation of the common bile duct were seen in 22 scans without a filling of the gallbladder, except 26 scans with the post-surgery. Morphological evaluation of the dilatation of the common bile duct on 99mTc-HIDA scan is of somewhat qualified value. So the dilatation of a bile ducts should be evaluated with recognition of morphological aspect as well as photographic aspect of a blooming phenomenon which may be encounted in a concentrated excretion of radiotracer into the biliary tree systems.
PracticeClinical medicine
Keywords99mTc-HIDA, Hepatobiliary, Scintigraphy

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