Journal of Okayama Medical Association
Published by Okayama Medical Association

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Full-text articles are available 3 years after publication.

(99m)Tc標識肝・胆道造影剤による体質性黄疸の経時的シンチグラフィー,ならびに肝細胞癌の陽性描出に関する研究

三谷 健 岡山大学医学部第一内科学教室
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Sequential 2 min scintiphotos were obtained with a scintilation camera after intravenous injection of 3mCi of (99m)Tc-HIDA or (99m)Tc-PI. Digital matrix images were simultaneously recorded with computer. Sequential samples for the blood clearance of (99m)Tc-HIDA or (99m)Tc-PI were obtained for 120 min following injection to the patient of constitutional hyperbilirubinemia and ICG excretory defect disease. In Dubin-Johnson syndrome, the hepatic uptake of (99m)Tc-HIDA was faster or normal but the excretion was extremely slower than in normal cases. Both hepatic uptake and excretion of (99m)Tc-PI were almost normal. In Rotor's disease, hepatic uptake of (99m)Tc-HIDA or (99m)Tc-PI was very poor, showing almost no hepatic images in all time. In Gilbert's disease and ICG excretory defect disease, hepatic uptake and excretion of (99m)Tc-HIDA or (99m)Tc-PI were within normal limit. From these results, Dubin-Johnson syndrome, Rotor's disease and Gilbert's disease show the different patterns between hepatic uptake and excretion of (99m)Tc-HIDA and (99m)Tc-PI hepatobiliary scintigraphy and these patterns contribute to the differential diagnosis of constitutional jaundice. The usefulness of hepatobiliary imaging with (99m)Tc-EHIDA in diagnosis of hepatocellular carcinoma was studied in 15 patients with histologically verified HCC. In 15 patients, 3 patients (20%) showed increased radioactivity with (99m)Tc-EHIDA image, where liver scan with (99m)Tc-Sn colloid showed filling defect. These results indicate that use of (99m)Tc-EHIDA scan and (67)Ga-citrate imaging is useful for positive visualization of HCC.
キーワード
体質性黄疸の鑑別
(99m)Tc-HIDA
(99m)Tc-PI
(99m)Tc-EHIDA
Dubin-Johnson症候群
Gilbert病
Rotor病
ICG排泄異常症
肝細胞癌の陽性描出
ISSN
0030-1558
NCID
AN00032489