Japanese
Title肝予備能評価における99mTc-GSA肝シンチグラフィ定量解析法の有用性 - 99mTc-PMT, 99mTc-Sn colloidとの比較 -
Subtitle原著
Authors秀毛範至*, 油野民雄*, 中嶋憲一*, 横山邦彦*, 孫保福*, 松田博史*, 村森朗*, 道岸隆敏*, 利波紀久*, 久田欣一*, 高山輝彦**, 種井政信***, 寺田光宏***, 鵜浦雅志***, 小林健一***
Authors(kana)
Organization*金沢大学医学部核医学教室, **金沢大学医療短期大学部, ***金沢大学医学部第一内科学教室
Journal核医学
Volume29
Number5
Page573-584
Year/Month1992/5
Article原著
Publisher日本核医学会
Abstract「要旨」99mTc-DTPA-galactosyl human serum albumin(99mTc-GSA)は, 肝アシアロ糖蛋白受容体との結合により肝に集積する新しい肝シンチグラフィ用剤であり, その肝集積の程度は肝予備能とよく相関することが知られている. 今回, 代償性肝硬変患者17例, 脂肪肝3例を対象として, 99mTc-GSAの肝予備能評価における有用性を従来の肝シンチグラフィ用剤である99mTc-PMT, 99mTc-Sn colloidと比較した. 肝の時間放射能曲線を解析して得られた肝クリアランス等の定量パラメータと, ヘパプラスチンテストや, アルブミン等の肝機能検査値との相関を求め, いずれのトレーサが肝機能指標と最も良好な相関を示すかを検討した結果, 99mTc-GSAより得られたパラメータが最も良好な相関を示した. また, 肝硬変重症度とも相関を示し, 肝シンチグラフィ定量解析法による肝予備能評価には99mTc-GSAが最も有用であると結論された.
Practice臨床医学：一般
Keywords99mTc-GSA, 99mTc-PMT, 99mTc-Sn colloid, Hepatic functional reserve, Quantitative analysis.
English
TitleThe Utility of Quantitative 99mTc-GSA Liver Scintigraphy in the Evaluation of Hepatic Functional Reserve : Comparison with 99mTc-PMT and 99mTc-Sn Colloid
SubtitleOriginal Articles
AuthorsNoriyuki SHUKE*, Tamio ABURANO*, Kenichi NAKAJIMA*, Kunihiko YOKOYAMA*, Bao-Fu SUN*, Hiroshi MATSUDA*, Akira MURAMORI*, Takatoshi MICHIGISHI*, Norihisa TONAMI*, Kinichi HISADA*, Teruhiko TAKAYAMA**, Masanobu TANEI***, Mitsuhiro TERADA***, Masashi UNOURA***, Kenichi KOBAYASHI***
Authors(kana)
Organization*Department of Nuclear Medicine, **School of Allied Medical Professions, ***First Department of Internal Medicine, Kanazawa University
JournalThe Japanese Journal of nuclear medicine
Volume29
Number5
Page573-584
Year/Month1992/5
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]Using data from 17 patients with liver cirrhosis and 3 patients with fatty liver, we have compared the utility of 3 hepatic imaging agents in the evaluation of hepatic functional reserve. Evaluated here were 99mTc-galactosyl human serum albumin (GSA) which is a new ligand for hepatic binding protein, 99mTc-N-pyridoxyl-5-methyl tryptophan (PMT) of a hepatobiliary agent, and 99mTc-Sn colloid. In each patient, we performed these 3 imaging studies within a week and also examined hepatic function tests (indocyanine green test, hepaplastin test, choline-esterase, etc). In each imaging study, serial images and dynamic data were obtained after the injection of 99mTc-GSA (185 MBq/3 mg), 99mTc-PMT (185 MBq), or 99mTc-Sn colloid (185 MBq). Using the obtained dynamic data, we analyzed the liver kinetics of the 3 agents based on 1 compartment model with 3 parameters (hepatic clearance, hepatic excretion rate, non-specific volume of distribution). From fitting the liver and heart data to this model, three unknown parameters were determined. Patlak plot was also applied in order to estimate liver uptake rate. Both curve fitting and Patlak plot could determine appropriate parameters in every study. In 99mTc-GSA, a nonlinear 3 compartment model was also applied in order to estimate hepatic blood flow, liver receptor density, and affinity of receptor-GSA binding separately. Using the obtained parameters, we analyzed the correlations between the parameters and the results of hepatic function tests. In all of the parameters, those obtained from 99mTc-GSA imaging showed the most significant statistical correlation with the results of hepatic function tests. From the present results, 99mTc-GSA imaging was concluded to be the best for evaluation of hepatic functional reserve.
PracticeClinical medicine
Keywords99mTc-GSA, 99mTc-PMT, 99mTc-Sn colloid, Hepatic functional reserve, Quantitative analysis.

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