Japanese
Title201Tl封入腸溶カプセル経口投与法による門脈循環動態の観察
Subtitle原著
Authors利波紀久*, 中嶋憲一*, 渡辺直人*, 瀬戸幹人*, 関宏恭*, 滝淳一*, 横山邦彦*, 高山輝彦*, 油野民雄*, 久田欣一*, 松井修**, 松下文昭***, 田中延善***, 小林健一***, 桑島章****, 須井修*****
Authors(kana)
Organization*金沢大学医学部核医学科, **放射線科, ***第一内科, ****東邦大学医学部大橋病院放射線科, *****徳島大学医学部放射線科
Journal核医学
Volume23
Number3
Page227-236
Year/Month1986/3
Article原著
Publisher日本核医学会
Abstract「要旨」201Tl封入腸溶カプセルを作製し基礎的検討を行ったのちに, 健常11例ならびに種々の肝疾患31例に経口的に投与し門脈血流動態をシンチグラフィと心・肝摂取比から観察した. また肝硬変例を主とする11例には201Tl経直腸法の結果と比較し検討した. 1. 201Tl封入腸溶カプセルは人工胃液内では崩壊せず, 人工腸液内で15分後にほぼ完全に溶けることを確認した. 2. 42例のうち十分に検査が施行しえたのは36例(86%)であった. 不成功例は胃内でのカプセル崩壊2例, カプセルの十二指腸への移行不良4例であった. 3. 健常者では肝は明瞭に描画され心・肝摂取比は0.32であった. これは経直腸法の心・肝摂取比に比べ高値である. 慢性肝炎, 急性肝炎の心・肝摂取比は健常者とほとんど同値であった. 肝硬変例では健常者に比べ少し高値であったが有意差はなく, 食道静脈瘤の存在する場合もとくに高値を示さなかった. 経直腸法で0.8以上の高い心・肝比を示した7例のうち経口法で同様に高値であったのは1例のみであり本例には上腸間膜静脈・下大静脈短絡が認められた. したがって, 上腸間膜静脈血の食道静脈瘤を介する短絡量は多くはないと考えられた. 4. 腸溶カプセルを用いたアイソトープの新しい投与法の可能性を強調した.
Practice臨床医学：一般
Keywords201Tl enclosed enteric coated capsule, Portal systemic circulation, Portal hypertension, Superior mesenteric vein.
English
TitleStudies on Portal Systemic Circulation by Oral Administration of 201Tl Enclosed Enteric Coated Capsule
SubtitleOriginal Articles
AuthorsNorihisa TONAMI*, Kenichi NAKAJIMA*, Naoto WATANABE*, Mikito SETO*, Hiroyasu SEKI*, Junichi TAKI*, Kunihiko YOKOYAMA*, Teruhiko TAKAYAMA*, Tamio ABURANO*, Kinichi HISADA*, Osamu MATSUI**, Fumiaki MATSUSHITA***, Nobuyoshi TANAKA***, Kenichi KOBAYASHI***, Akira KUWAJIMA****, Osamu SUI*****
Authors(kana)
Organization**Department of Nuclear Medicine, **Department of Radiology, ***The First Department of Internal Medicine, School of Medicine, Kanazawa University, ****Department of Radiology, Ohashi Hospital, School of Medicine, Toho University, *****Department of Radiology, School of Medicine, Tokushima University
JournalThe Japanese Journal of nuclear medicine
Volume23
Number3
Page227-236
Year/Month1986/3
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractThallium-201 enclosed enteric coated capsule was prepared and administered orally to evaluate portal systemic circulation in 11 control subjects and 31 patients with various liver diseases by investigating scintigraphic appearance and the heart-to-liver uptake ratio (H/L ratio). In 10 patients with liver cirrhosis and one with chronic hepatitis, the results of H/L ratio were compared to those obtained by 201Tl per-rectal administration. 1. It was fundamentally confirmed that 201Tl enclosed enteric coated capsule was not broken down in the artificial gastric juice, but nearly completely melted 15 minutes after soaking in the artificial intestinal juice. 2. Clinical study was successfully completed in 36 out of 42 cases (86%). Unsuccessful cases were found in 2 with capsule collapse in the stomach and 4 with its poor moving to the duodenum. 3. In control subjects the liver was clearly visualized and the mean value of H/L ratio was 0.32 which is lower than that of 201Tl per-rectal administration previously reported. H/L ratio in patients with chronic and acute hepatitis was nearly equal to that in control subjects. H/L ratio in patients with liver cirrhosis was slightly higher than that in control subjects, but there was no significant difference between them. In cases with esophageal varices, H/L ratio was not so high compared to that in control subjects. Out of 7 patients showing high H/L ratio more than 0.8 in 201Tl per-rectal administration, only one showed similar high ratio (1.07) in oral administration of 201Tl enclosed enteric coated capsule. In this case the shunting from superior mesenteric vein to inferior vena cava connection was confirmed. From these results, it was considered that the shunting volume of superior mesenteric vein through esophageal varices is small. 4. A possibility of a new administration of radioisotope with enteric coated capsule was emphasized.
PracticeClinical medicine
Keywords201Tl enclosed enteric coated capsule, Portal systemic circulation, Portal hypertension, Superior mesenteric vein.

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