Sequential 2 min scintiphotos were obtained with a scintilation camera after intravenous injection of 3mCi of
99mTc-HIDA or
99mTc-PI. Digital matrix images were simultaneously recorded with computer. Sequential samples for the blood clearance of
99mTc-HIDA or
99mTc-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
99mTc-HIDA was faster or normal but the excretion was extremely slower than in normal cases. Both hepatic uptake and excretion of
99mTc-PI were almost normal. In Rotor's disease, hepatic uptake of
99mTc-HIDA or
99mTc-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
99mTc-HIDA or
99mTc-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
99mTc-HIDA and
99mTc-PI hepatobiliary scintigraphy and these patterns contribute to the differential diagnosis of constitutional jaundice. The usefulness of hepatobiliary imaging with
99mTc-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
99mTc-EHIDA image, where liver scan with
99mTc-Sn colloid showed filling defect. These results indicate that use of
99mTc-EHIDA scan and
67Ga-citrate imaging is useful for positive visualization of HCC.
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