| Japanese |
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| Title | 99mTcO4-経直腸門脈シンチグラフィによる門脈循環動態の診断 |
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| Subtitle | 原著 |
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| Authors | 塩見進*, 黒木哲夫*, 倉井修*, 池岡直子*, 箕輪孝美*, 針原重義*, 小林絢三*, 門奈丈之**, 越智宏暢***, 小野山靖人*** |
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| Authors(kana) | |
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| Organization | *大阪市立大学医学部第三内科, **公衆衛生, ***放射線科 |
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| Journal | 核医学 |
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| Volume | 24 |
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| Number | 4 |
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| Page | 407-415 |
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| Year/Month | 1987/4 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」門脈循環動態を非観血的に観察するために, 99mTcO4-を直腸腔内に注入する方法を試み, その臨床応用の有用性について検討した. 1. 99mTcO4-が下腸間膜静脈, 門脈, 肝臓心臓の順に流れるため, 5分間の積算イメージにおいて門脈肝臓で高いactivityを示すが心臓のactivityの低いPattern I, RNが下腸間膜静脈末梢部の側副血行路を経て大循環系へと流入するため, 積算イメージにおいて心臓が高いactivityを示し門脈, 肝臓のactivityの低いPattern IIに大別された. 2. Pattern Iは健常例6例, 慢性非活動性肝炎29例, 慢性活動性肝炎30例, 大酒家の肝線維症16例の全例および肝硬変156例中54例(35%)にみられ, Pattern IIは肝硬変156例中102例(65%)にみられた. 3. 肝臓および心臓における関心領域のtime-activity curveを解析することにより経直腸門脈シャント率を算出した. 経直腸門脈シャント率は肝病変の進展に伴い増加し, 特に肝硬変において高値を示した. さらに, 食道静脈瘤合併群, 肝性脳症出現群においてそれぞれ非合併群に比べ有意の高値を示した. 4. 門脈圧亢進を示す症例の一部において門脈系側副血行路の描出や, 血管吻合術による門脈血行路の変化を画像的にとらえることが可能であった. 以上より本検査法は非観血的に門脈循環動態の測定が可能であり, 臨床的にも十分応用可能であると思われた. |
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| Practice | 臨床医学：一般 |
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| Keywords | 99mTcO4-, Per-rectal portal scintigraphy, Portal circulation. |
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| English |
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| Title | Evaluation of Portal Circulation by 99mTcO4- Per-rectal Scintigraphy |
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| Subtitle | Original Articles |
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| Authors | Susumu SHIOMI*, Tetsuo KUROKI*, Osamu KURAI*, Naoko IKEOKA*, Takami MINOWA*, Shigeyoshi HARIHARA*, Kenzo KOBAYASHI*, Takeyuki MONNA**, Hironobu OCHI***, Yasuto ONOYAMA*** |
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| Authors(kana) | |
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| Organization | *Third Department of Internal Medicine, **Department of Public Health, ***Department of Radiology, Osaka City University Medical School |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 24 |
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| Number | 4 |
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| Page | 407-415 |
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| Year/Month | 1987/4 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary]Portal circulation in patients with chronic liver diseases was evaluated by a new method named per-rectal portal scintigraphy. Following instillation of a solution containing 10 mCi of 99mTcO4- into the upper part of the rectum, serial scintigrams were taken sequentially. At the same time, the radioactivity curves over the liver and the heart were recorded sequentially. 1) The findings of per-rectal portal scintigrams were classified into two basic patterns. In pattern (I), the inferior mesenteric vein, portal vein, liver and the heart were visualized continuously after rectal instillation of the radioisotope. This pattern reflects direct blood flow from the rectum to the liver via the portal vein. In contrast, in pattern (II), the portal scintigrams demonstrated the vena cava inferior and the heart at an early phase when neither the portal system nor the liver have received the isotope. This pattern indicates that a part or all of the blood flow from the rectum is directed to the vena caval system via the portacaval shunts on the periphery of the inferior mesenteric vein. 2) Per-rectal portal shunt indices (SI) were calculated from serial radioactivities on the liver and the heart. In the healthy subjects, SI ranged from 1.9% to 5.2% (mean 4.1 %). In patients with hepatitis the mean SI was 6.9 %, and in patients with cirrhosis it was 52.9 %. 3) The SI was higher in cirrhotic patients with esophageal varices than in those without (p<0.001). The SI was higher in cirrhotic patients with encephalopathy than in those without (p<0.01). Thus, per-rectal portal scintigraphy is a simple, noninvasive and practical method for analyzing portal hemodynamics. |
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| Practice | Clinical medicine |
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| Keywords | 99mTcO4-, Per-rectal portal scintigraphy, Portal circulation. |
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