Japanese
Title99mTc-Galactosyl Human Serum Albumin肝シンチグラフィを用いた肝機能評価の有用性の検討
Subtitle原著
Authors福井弘幸*, 柏木徹*, 笠原彰紀**, 平松直樹**, 松永隆**, 尾下正秀**, 後藤守孝**, 竹井謙之**, 林紀夫**, 川野淳**, 房本英之**, 木村和文*, 小塚隆弘*, 鎌田武信**
Authors(kana)
Organization*大阪大学医学部附属病院中央放射線部, **第一内科
Journal核医学
Volume28
Number11
Page1333-1341
Year/Month1991/11
Article原著
Publisher日本核医学会
Abstract「要旨」肝細胞膜受容体に特異的に結合する合成糖蛋白(Galactosyl Human Serum Albumin)にDTPAを介して99mTcを標識した99mTc-GSAを用いて, 15例の慢性肝疾患患者を対象に肝シンチグラフィを行い, 肝疾患診断における有用性を検討した. その結果, 肝硬変症全例で99mTc-GSA注射40分後に心陰影が残存し, 高度肝障害例では肝イメージングが99mTc-phytateや99mTc-PMTに比し劣る場合があると考えられた. 定量解析では, 心および肝動態曲線のコンピュータ解析より得られた血中消失率, 肝摂取率(Ku), Peak Time(PT)は, 慢性肝炎群と肝硬変群で有意差を認め, 血清肝機能指標と相関を示した. また, Ku, PTは肝組織のfibrosisの程度と相関を示したが, 99mTc-phytateや99mTc-PMTでは同様の結果が得られなかった. 以上から, 99mTc-GSAを用いた肝シンチグラフィは, 慢性肝疾患の診断に有用で, さらに, 従来のRI tracerを用いた検査とは異なる新しい肝機能評価法になり得ると考えられた.
Practice臨床医学：一般
Keywords99mTc-GSA, Liver scintigraphy, Computer analysis, Liver function test, Hepatic fibrosis.
English
TitleEvaluation of Usefulness of Tc-99m-GSA Liver Scintigraphy in Chronic Liver Diseases
Subtitle
AuthorsHiroyuki FUKUI*, Toru KASHIWAGI*, Akinori KASAHARA**, Naoki HIRAMATSU**, Takashi MATSUNAGA**, Masahide OSHITA**, Moritaka GOTO**, Yoshiyuki TAKEI**, Norio HAYASHI**, Sunao KAWANO**, Hideyuki FUSAMOTO**, Kazufumi KIMURA*, Takahiro KOZUKA*, Takenobu KAMADA**
Authors(kana)
Organization*Division of Nuclear Medicine, Osaka University Hospital, **First Department of Medicine, Osaka University Medical School
JournalThe Japanese Journal of nuclear medicine
Volume28
Number11
Page1333-1341
Year/Month1991/11
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]Liver scintigraphy was performed using a newly developed radiopharmaceutical, Tc-99m-DTPA-Galactosyl-Human-Serum-Albumin (Tc-99m-GSA), which binds specifically to the receptors on the hepatic cell surface, in 15 patients with chronic liver diseases. The scintigraphy was evaluated qualitatively and quantitatively, and the results were compared with those obtained from the Tc-99m-PMT or Tc-99m-sn-phytate scintigraphy, and the liver function tests. The Tc-99m-GSA scintigraphy showed clear liver images in chronic hepatitis. However, in liver cirrhosis, the liver images was not clear and the cardiac images still existed 40 minutes after administration of Tc-99m-GSA, suggesting that the image quality of the Tc-99m-GSA scintigrams may be inferior to that of Tc-99m-sn-phytate or Tc-99m-PMT in some cases of severe liver dysfunction. The time-activity curves of the heart and liver were analyzed by non-linear regression analysis. The clearance rate from plasma (Kd) were obtained from the time-activity curve of the heart, and the hepatic uptake rate (Ku), hepatic excretion rate (Ke) and peak time of hepatic uptake-excretion curve (PT) were obtained from the time-activity curve of the liver. Kd, Ku and PT values were more significantly decreased or prolonged in the patients with liver cirrhosis than those in the patients with chronic hepatitis. Kd, Ku and PT values had positive correlations with the result of the serum liver function tests, ICG-R15 and ICG-K. Ku and PT values had also correlations with the histological degrees of hepatic fibrosis. On the other hand, the indices obtained using Tc-99m-PMT or Tc-99m-sn-phytate did not have correlations with the histological degrees of hepatic fibrosis. It is concluded that the liver scintigraphy using Tc-99m-GSA may be useful and give different informations from those with conventional liver scintigraphies in evaluating chronic liver diseases.
PracticeClinical medicine
Keywords99mTc-GSA, Liver scintigraphy, Computer analysis, Liver function test, Hepatic fibrosis.

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