Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intrahepatic shunt ratio was calculated from the fraction of the uptake constant and the blood background, analyzing the data of 99mTc-(Sn)-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) hepatobiliary imaging by Rutland method. Shunt flow and total hepatic blood flow (THBF) were also calculated from the values for the effective hepatic blood flow (EHBF) estimated from the blood clearance technique. In 15 cases of normal volunteer, the average of the shunt ratio, shunt flow, and THBF were 18.4 +/- 5.4 (S.D.)%, 137.8 +/- 49 ml/min, and 753 +/- 83.2 ml/min, respectively. In 8 cases of chronic hepatitis, the values were 35.2 +/- 2.6%, 276 +/- 55.4 ml/min, and 794.1 +/- 119.4 ml/min, respectively. In 12 cases of liver cirrhosis, the values were 51.4 +/- 12.6%, 353.9 +/- 141.3 ml/min, and 685.6 +/- 174.8 ml/min, respectively. In cases of chronic hepatitis and liver cirrhosis, in comparison with normal cases, the values for the shunt ratio and shunt flow were significantly increased (p less than 0.001) and those for EHBF were significantly decreased (p less than 0.001), but those for THBF were not significantly altered. There was a significant inverse correlation between the shunt ratio and EHBF (r = -0.842) in all 35 cases. This method is considered to be useful for differential diagnosis, estimation of the grade of the diseases, and evaluation of pathophysiology of various diffuse liver diseases.
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PMID:[Measurement of intrahepatic shunt using Rutland method]. 202 Jan 29

For assessment of the value of delayed hepatobiliary imaging with technetium 99m (99mTc)-(Sn)-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) for specific diagnosis of hepatocellular carcinoma, 88 patients with various malignant and benign liver diseases (49 with hepatocellular carcinoma, 4 with cholangiocellular carcinoma, 10 with metastatic liver carcinoma, 2 with liver cysts, 2 with liver hemangioma, 1 with liver abscess, 2 with intrahepatic lithiasis, 12 with liver cirrhosis, and 6 with chronic hepatitis) were studied. In 20 (41%) of the 49 patients with hepatocellular carcinoma, greater uptake of 99mTc-PMT by the tumor than by the surrounding liver tissue was seen in delayed hepatobiliary images, whereas in eight patients (16%), equilibrated uptake was seen. No increased uptake of the radioisotope by hepatic lesions was seen in 21 patients with localized liver diseases other than hepatoma. Moreover, in 18 patients with diffuse liver diseases, no focal accumulation of the radioisotope was seen in delayed 99mTc-PMT images. In addition, of 28 patients with hepatocellular carcinoma in whom the serum alpha-fetoprotein level showed little or no increase, 12 showed increased uptake of 99mTc-PMT by the tumor. In assessing delayed 99mTc-PMT images, however, it was necessary to consider following complications: accumulation of tracer in obstructed and dilated biliary trees; retention of radioactivity in nonneoplastic liver tissues; difficulties in evaluating 99mTc-PMT uptake by small hepatic tumors; overlapping of radioactivity in the gut and gallbladder in delayed 99mTc-PMT images of tumors. This study indicates that delayed 99mTc-PMT images can be useful in the diagnosis of hepatocellular carcinoma.
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PMID:Specific diagnosis of hepatocellular carcinoma by delayed hepatobiliary imaging. 241 74

Factor analysis of hepatobiliary scintigraphy using 99mTc-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) was performed, and functional factor of liver parenchyma (FA-hepatogram) was obtained. Two parameters (peak time, T 1/2) were calculated from this hepatogram. A good correlation was obtained between these parameters and ICG-R15; furthermore, these parameters were prolonged in patients with normal volunteers, chronic hepatitis, compensated and decompensated liver cirrhosis in this order. Conventional hepatogram by ROI method (ROI-hepatogram) was not suitable for the evaluation of global liver function in condition such as a large intrahepatic mass, intrahepatic gall bladder, dilatation of biliary tree, and severe liver cirrhosis. But, even in such cases, FA-hepatogram was useful for the evaluation of global liver function.
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PMID:[Evaluation of hepatic function by hepatobiliary scintigraphy using factor analysis]. 273

99mTc-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) hepatograms were analyzed to provide information about the liver and bile duct. Calculations were based on a four compartmental model and included corrections for blood, tissue, hepatic parenchymal and bile backgrounds. The time activity curves for 99mTc-PMT in the cardiac region were described as the sum of two exponential functions, while curves for the hepatic regions were described as the sum of three exponential components. The measured hepatograms were compared with simulations and good agreement between the two curves showed that the compartmental model adequately described the blood and bile activities in vivo. Hepatic excretion rate constants were 0.179 +/- 0.026 in three normal subjects, 0.102 +/- 0.012 in four patients with chronic hepatitis and 0.082 +/- 0.034 in six patients with liver cirrhosis. In the case of diffuse parenchymal liver disease, there were lower rate constants for the excretion from the liver to the bile ducts than in normals, and the relative distribution volumes were also larger than normal. Prior to the development of this compartmental model, no useful kinetic model had been found which could satisfactorily explain the time activity curves. Experience in human studies proves this method to be accurate in determining the rate constants for the hepatobiliary transport of 99mTc-PMT.
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PMID:Quantitative analysis by digital computer of 99mTc-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) hepatogram in diffuse parenchymal liver diseases. 366 77

The noninvasive determination of effective hepatic blood flow, intrahepatic shunted blood flow, intrahepatic shunt index, and total hepatic blood flow was investigated by using the sequential single photon emission computed tomography. This method was performed for a period of 10 minutes following an intravenous injection of 99mTc-(Sn)-N-pyridoxyl-5-methyltryptophan and a venous blood sampling. This study comprised 8 healthy volunteers, 16 patients with chronic hepatitis, and 33 patients with liver cirrhosis. The intrahepatic shunt index measured with this method coincided with the intrahepatic shunt index determined by catheterization, indicating the high reliability of this procedure. The effective hepatic blood flow in patients with liver cirrhosis was significantly lower than that in the healthy controls and the chronic hepatitis group. The intrahepatic shunted blood flow was significantly higher in patients with liver cirrhosis compared with the flow in healthy controls. The intrahepatic shunt index was also significantly higher in patients with liver cirrhosis compared with the index of healthy controls and those with chronic hepatitis. No substantial differences were noted in the total hepatic blood flow among the three groups. The effective hepatic blood flow, the intrahepatic shunted blood flow, and the intrahepatic shunt index, correlated with the serum albumin concentration, the serum cholinesterase level, and the plasma indocyanine green attenuation rate. From these results, it was concluded that the present procedure constitutes a reliable and effective method for the noninvasive determination of hepatic blood flows. Consequently, it will be of high clinical value for assessing the functional and the pathological alterations of the liver.
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PMID:Single photon emission computed tomography to determine effective hepatic blood flow and intrahepatic shunting. 784 6

Measuring the hepatic extraction fraction (HEF) of a hepatobiliary radiopharmaceutical helps to differentiate hepatocyte from biliary tract diseases, and it is generally performed using deconvolution analysis. In this study, we measured HEF using spectral analysis. With spectral analysis, HEF was calculated from (the sum of the spectral data obtained by spectral analysis--the highest frequency component of the spectrum) divided by (the sum of the spectral data) x 100 (%). We applied this method to dynamic liver scintigraphic data obtained from six healthy volunteers and from 46 patients with various liver diseases, using 99Tcm-N-pyridoxyl-5-methyltryptophan (PMT). We also measured HEF using deconvolution analysis, in which the modified Fourier transform technique was employed. The HEF values obtained by spectral analysis correlated closely with those obtained by deconvolution analysis (r = 0.925), suggesting our method is valid. The HEF values obtained by spectral analysis decreased as the severity of liver disease progressed. The values were 100.0 +/- 0.0%, 94.7 +/- 13.6%, 76.2 +/- 27.4%, 45.7 +/- 15.6%, 82.7 +/- 24.2% and 95.2 +/- 11.8% (mean +/- S.D.) for the normal controls (n = 6), mild liver cirrhosis (n = 16), moderate liver cirrhosis (n = 11), severe liver cirrhosis (n = 5), acute hepatitis (n = 8) and chronic hepatitis groups (n = 6), respectively. The HEF was obtained more simply and rapidly by spectral analysis than by deconvolution analysis. The results suggest that our method using spectral analysis can be used as an alternative to the conventional procedure using deconvolution analysis for measuring HEF.
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PMID:Hepatic extraction fraction of hepatobiliary radiopharmaceuticals measured using spectral analysis. 1057 14

Although it is recognized that hepatobiliary scan is of value in assessing postoperative complications of biliary surgery or cadaveric whole liver transplantation, there have been few reports regarding its usefulness following living donor liver transplantation. We performed living donor liver transplantation in a patient with biliary cirrhosis due to hepatolithiasis, using a right lobe graft from her sister. On the 15th postoperative day, bile discharge appeared from the operative wound. The leakage point could not be identified by computed tomography and cholangiography from the biliary drainage catheter. Hepatobiliary scan with Tc-99m Sn-N-pyridoxyl-5-methyltryptophan (99mTc-PMT) demonstrated biliary extravasation from the left side of the anastomosis of the hepatico-jejunostomy, indicating biliary leakage from the anastomosis. Conservative therapy was continued because the radioisotope flowed smoothly into the reconstructed jejunum and the biliary drainage catheter, and the leakage was stopped on the 63th postoperative day. Hepatobiliary scan is useful in determining the therapeutic plan as well as detection of bile leakage and identification of leakage points after living donor liver transplantation.
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PMID:Bile leakage after living donor liver transplantation demonstrated with hepatobiliary scan using 9mTc-PMT. 1457 89