| Japanese |
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| Title | 99mTc-GSA肝シンチグラフィの視覚的評価 - 読影者間変動, 読影者内変動の検討 - |
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| Subtitle | 原著 |
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| Authors | 河相吉*, 甲田勝康*, 西田卓郎*, 菅豊*, 田中敬正*, 是枝ちづ**, 井上恭一** |
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| Organization | *関西医科大学放射線科, **第三内科 |
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| Journal | 核医学 |
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| Volume | 33 |
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| Number | 1 |
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| Page | 1-7 |
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| Year/Month | 1996/1 |
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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」99mTc-GSA肝シンチグラフィの新しい定義にもとづく視覚的評価の有効性について検討した. 対象は各種肝疾患患者104例である. 3mg/185 MBqの99mTc-GSAを静注投与し, 5分後の胸腹部前面像を次の定義に従って分類した. すなわちGrade I, 心プール像の描出が弱くその辺縁までは認められないもの ; Grade II, 心プール像は辺縁まで認められるが肝よりも明らかに弱いもの ; Grade III, 心プール像と肝の集積程度がほぼ同程度であるもの ; Grade IV, 心プール像が肝集積より明らかに強いもの, 以上の4段階である. 放射線科医3名が, 協議することなく別個に2回の読影を行いImaging Gradeを算出した. 読影者間変動, 読影者内変動はκテストにより検討した. κ値は異なる読影者間での一致性について平均0.88, 同一読影者における再現性について平均0.87ときわめて良好な成績を得た. またLHL15, HH15, LHL/HH, Rmaxなどの定量的指標とImaging Gradeは良好な対応を示し, Grade別の各指標はいずれも有意差を示した. ICG 15分後血漿停滞率はGrade II以下とGrade III以上の間で有意差を示した. シンチ画像をもとにした99mTc-GSAの4段階法視覚的Grade分類は再現性に優れた簡便な肝機能評価法として有用である. |
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| Practice | 臨床医学：一般 |
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| Keywords | 99mTc-GSA, Liver scintigraphy, Interobserver variability, Intraobserver variability. |
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| English |
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| Title | Visual Evaluation of Liver Function with 99mTc-GSA Scintigraphy : Interobserver Variation and Intraobserver Variation |
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| Authors | Sang Kil HA-KAWA*, Katsuyasu KOUDA*, Takuroh NISHIDA*, Yutaka SUGA*, Yoshimasa TANAKA*, Chizu KOREEDA**, Kyoichi INOUE** |
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| Authors(kana) | |
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| Organization | *Department of Radiology, Kansai Medical University, **Third Department of Internal Medicine, Kansai Medical University |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 33 |
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| Number | 1 |
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| Page | 1-7 |
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| Year/Month | 1996/1 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary]We introduced a new imaging grade to evaluate liver function with 99mTc-GSA and studied its diagnostic value using interobserver variation and intraobserver variation. One hundred four patients with liver disease were injected 185 MBq/3 mg of 99mTc-GSA. Anterior images of cardiac blood-pool and liver at 5 min after injection were divided into four grades on the basis of following four categories. Faint cardiac blood-pool image, without clear demonstration of its peripheral boundary was classed in grade I ; weaker cardiac blood-pool than liver was grade II ; almost same appearance of blood-pool with liver was grade III and stronger blood-pool than liver was grade IV. Three radiologists reviewed the images independently. They followed the same process three months after initial evaluation. κ-Test was employed to evaluate the goodness of agreement. Three pairs in the first reading showed excellent interobserver agreement (0.88, mean κ-value) and another three pairs in the first and second reading also showed excellent intraobserver agreement (0.87, mean κ-value). Quantitative indices obtained from time-activity curves for blood-pool and liver showed significant differences across four groups. Plasma retention rate of indocyanine green also showed significant difference between grade II and grade III. Imaging grade possesses high intra-and interobserver agreement and provides a good discrimination for liver function. |
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| Practice | Clinical medicine |
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| Keywords | 99mTc-GSA, Liver scintigraphy, Interobserver variability, Intraobserver variability. |
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