Angiohepatogram in Diffuse Hepatic Disease

Abstract

Since some years ago, radioisotope angiography of the liver has been mainly used to evaluate the vascular state of focal hepatic lesions. With both scintillation camera and a short half life radionuclide, it became possible to separate the distribution of blood supply to the liver into arterial and portal components. On the other hand, it is known that the relative distribution of blood supply to the liver is altered in various diffuse hepatic diseases. In the present study, a region of interest (ROI) angiohepatogram was obtained with intravenous injection of 10mCi of^89mTc-Sn-colloid and a data processing system. Furthermore, the ratio of hepatic arterial blood flow volume to total hepatic blood flow volume was calculated according to Ueda's method, and the correlation of this calculated ratio and the degree of extrahepatic distribution of^99mTC-Sn-colloid (spleen to liver, and bone marrow to liver activity ratio) was examined.
The obtained results are as follows:
1) Most of liver cirrhosis and Banti's syndrome showed the increased hepatic arterial blood flow ratio (liver cirrhosis: 43.5±9.5%, Banti's syndrome 48.8±4.9%) in contrast with 18.1±4.6% in normal case, and its ratio showed much higher values in the presence of portal hypertension manifestations (esophageal varix and ascites) .
2) The hepatic arterial blood flow ratio showed increased values in the case of markedly increased extrahepatic activity, e. g. liver cirrhosis, and the correlation of the ratio and extrahepatic activity degree of^99mTc-Sn-colloid was significant statistically.
From these results, a region of interest (ROI) angiohepatogram was supposed to be useful for the prediction of the henaodynamic change as well as the improvement of diagnostic accuracy with radioisotope in diffuse hepatic disease, especially liver cirrhosis. Moreover, the hemodynamic change of liver, especially the reduction of the effective hepatic blood flow volume via the portal vein was considered to be closely concerned in the mechanism of increased extrahepatic activity of RI colloid in dffuse hepatic disease.