Japanese
Title99mTc-pyridoxylideneisoleucine (99mTc-PI) による肝・胆道の連続シンチフォトグラフィ - 特にDubin-Johnson症候群に関する検討 -
Subtitle原著
Authors三谷健*, 湯本泰弘*,**, 長島秀夫*, 武田和久*, 徳山勝之**, 神野健二**, 山本博**, 和田俊裕**, 森田稔**, 丸山久**
Authors(kana)
Organization*岡山大学医学部第1内科教室, **四国がんセンター
Journal核医学
Volume17
Number5
Page553-564
Year/Month1980/6
Article原著
Publisher日本核医学会
Abstract「要旨」肝・胆道疾患75例と健常例9例を対象として, 99mTcPI 3 mCiを静注し連続肝シンチフォトグラフィを行なった. 健常例では8〜10分で肝内胆管, 総胆管が, 20分で小腸, 胆嚢が描出された. 99mTc-PIの尿中排泄率は2時間で投与量の11.0±52%を示した. (1) 131I-BSPの著明な胆道排泄の停滞と, 99mTc-N- (2, 6-dimethylphenylcarbamoylmethyl) iminodiacetic acid (HIDA) の排泄遅延を示したDubin-Johnson症候群2例;131I-BSPの正常排泄を示すGilber病1例およびICG異常停滞症1例では99mTcPIは正常排泄状態を示し, これらの疾患においては色素により排泄態度をことにした. (2) 肝実質障害, 肝内胆汁うっ滞, 胆汁性肝硬変で黄疸を有する患者では99mTc-PIの肝臓への摂取と排泄能が低下し, 尿中への排泄率は増加した. (3) 胆道の完全閉塞例では18時間後に腸管内のRI像は描出出来ないのに対して, 不完全閉塞例および高度肝障害例では腸管内のRI像をみとめた. (4) 肝内胆管の部分的不完全閉塞と診断した8例中6例では肝内胆管結石, 1例は肝細胞癌による圧迫, 1例は肝硬変であった. 本法は肝内の部分的胆管閉塞, 排泄障害の診断に有用である.
Practice臨床医学：一般
KeywordsTc-99m-PI, hepatobilliary scintipoto, Dubin-Johnson syndrome, incomplete obstruction of hepatic bile duct
English
TitleScintiphotography of Hepatobiliary System with 99mTc-pyridoxylideneisoleucine (PI) : Special Reference to Cases of Dubin-Johnson Syndrome
SubtitleOriginal Articles
AuthorsKen MITANI, Yasuhiro YUMOTO, Hideo NAGASHIMA, Kazuhisa TAKETA
Authors(kana)
OrganizationThe First Department of Internal Medicine, Okayama University Medical School
JournalThe Japanese Journal of nuclear medicine
Volume17
Number5
Page553-564
Year/Month1980/6
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Sequential 2-min scintiphotos were obtained with a scintillation camera after intravenous administration of 4 mCi of 99mTc-PI. Digital matrix images were simultaneously recorded on a digital magnetic tape through a data storage and analysis system with computer. Late images of the abdomen were obtained 18 hr after injection. Sequential samples for the blood clearance of 99mTc-PI were obtained for 120 min following injection. Time activity curve for blood clearance and that over the liver were simmulated by two or three exponential functions. Subjects comprised of 35 cases, including 5 chronic hepatitis, 2 acute hepatitis, 10 liver cirrhosis, 3 choledocholithiasis, 2 bileduct carcinoma, 3 constitutional jaundice, 2 hepatoma, 3 intrahepatic cholestasis, and 5 normal control cases. In normal controls, biliary tract and gallbladder were within 8-10 min of injection and marked accumulation of radioactivity in biliary system and gastrointestinal tract was noted at 20 min. Cumulative 120 min urine contained 11+-1.5% of the injected dose, In 2 cases of Dubin-Johnson syndrome with abnormal retention of 131I-BSP and 99mTcHIDA, two of Gilbert's disease and one with abnormal retention of ICG. each with almost normal retention of 131I-BSP, sequential scintiphoto showed normal images. In jaundiced patients, blood clearance of the tracer was delayed and urinary excreation increased, but intestinal activity was imaged in those patients without complete obstruction of common bile duct. Of 5 diagnosed by the scan as partial obstruction in left hepatic lobe, its two had calculi in the biliary tree, one primary biliary cirrhosis, one hepatoma, and one chronic hepatitis. All of these patients were subsequently shown to have partial obstruction by retrograde cholangiopancreatography, percutaneous transhepatic cholangiography, biopsy of the liver or laparotomy. Sequential hepatobiliary scintiphotography using 99mTc-PI proved useful for diagnosis of the partial obstruction of intrahepatic bile duct.
PracticeClinical medicine
KeywordsTc-99m-PI, hepatobilliary scintipoto, Dubin-Johnson syndrome, incomplete obstruction of hepatic bile duct

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