| Japanese |
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| Title | 99mTc-GSA肝シンチグラフィを用いた肝切除リスクの術前評価 |
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| Subtitle | 原著 |
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| Authors | 長谷部伸*, 國安芳夫*, 新尾泰男*, 篠原広行*, 内山勝弘*, 永島淳一*, 金潤吉** |
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| Organization | *昭和大学藤が丘病院放射線科, **昭和大学藤が丘病院外科 |
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| Journal | 核医学 |
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| Volume | 34 |
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| Number | 12 |
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| Page | 1119-1124 |
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| Year/Month | 1997/12 |
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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」肝切除症例において術前の99mTc-GSA肝シンチグラフィによる肝予備能定量指標と肝切除率を組み合わせた index を考案し, 術後の合併症発現の有無と比較して切除リスク評価における有効性について検討した. 対象は肝切除術が施行された38例で, そのうち7例に合併症が認められ, 2例が肝不全により死亡した. 全症例に, 肝切除術前2週間および術後1週間以内の2回の99mTc-GSA肝シンチグラフィ検査を実施し, そのSPECT像から肝切除後の残肝容積率を retrospective に求めた. 術前のGSA指標HH15の逆数(1/HH15)およびLU15に残肝容積率を乗じたものを resectability index (Res) として今回の検討に用いた. 結果は, いずれのResも無合併症群と有合併症群の分布に有意差を認め, 両群を分離し得た. したがって, 術前に肝切除域を推定しResを算出すれば, 安全域内の肝切除決定に有用であると考える. |
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| Practice | 臨床医学：一般 |
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| Keywords | 99mTc-GSA (galactosyl human serum albumin), Hepatic resection, Hepatic functional reserve, Resectability index |
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| English |
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| Title | Preoperative Evaluation of the Limitation of Hepatic Resection Using 99mTc-GSA (Galactosyl Human Serum Albumin) Scintigraphy |
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| Subtitle | Original Articles |
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| Authors | Shin HASEBE*, Yoshio KUNIYASU*, Yasuo NIIO*, Hiroyuki SHINOHARA*, Katsuhiro UCHIYAMA*, Junichi NAGASHIMA*, Junkichi KIN** |
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| Authors(kana) | |
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| Organization | *Department of Radiology, Showa University Fujigaoka Hospital, **Department of Surgery, Showa University Fujigaoka Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 34 |
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| Number | 12 |
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| Page | 1119-1124 |
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| Year/Month | 1997/12 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | Preoperative evaluation of the operative indication of hepatic resection using the parameters obtained by 99mTc-GSA scintigraphy has been done. In particular, the accurate evaluation of the postoperative hepatic functional reserve essentially depends on these parameters. In the present study, a preoperative evaluation of postoperative hepatic functional reserve using 99mTc-GSA scintigraphy was performed in our operated cases retrospectively. Patients and Methods: Thirty-eight patients who underwent hepatic resection were studied on 99mTc-GSA scintigraphy before and after operation. These patients were divided into two groups. Group A; had no postoperative complications (n = 31). Group B; had some postoperative complications (n = 7). Preoperative parameters of 99mTc-GSA liver scintigraphy (HH15, LU15) were calculated from the activities of liver and cardiac ROIs at 5 and 15 minutes after injection. The resection ratio (RR) was obtained by comparing the liver volumes which were calculated from the pre- and postoperative SPECT studies. The resectability indices (Res) were as follows: Res(LU15) = LU15×(100 - RR(%))/100, Res(HH15) = (1/HH15)×(100 - RR(%))/100. Results: There were statistically significant differences in the distribution of Res between A and B groups (p = 0.002, Mann-Whitney test). The values of Res, of which half of patients have complication, were 1.10 (Res(HH15)) and 16.4 (Res(LU15)). Conclusion: The resectability indices using 99mTc-GSA liver scintigraphy are useful for the preoperative evaluation of the limitation of hepatic resection. |
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| Practice | Clinical medicine |
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| Keywords | 99mTc-GSA (galactosyl human serum albumin), Hepatic resection, Hepatic functional reserve, Resectability index |
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