We report a 61-year-old asymptomatic man who had a hepatic lesion whose nature was undetermined, based on biochemistry, serology, ultrasonography, computed tomography, and magnetic resonance imaging studies. Biliary h...We report a 61-year-old asymptomatic man who had a hepatic lesion whose nature was undetermined, based on biochemistry, serology, ultrasonography, computed tomography, and magnetic resonance imaging studies. Biliary hamartomas were diagnosed by echo-guided needle biopsy. Functional studies of bile excretion, using 99mTc-diisopropyl iminodiacetic acid (99mTc-DISIDA) scintigraphy liver single-photon emission computed tomography (SPECT) showed the delayed transit of tracers from hepatocytes to the biliary hamartomas and the delayed emptying of tracers to the neighboring bile ducts. Therefore, biliary hamartomas should be included in the differential diagnosis of single or multiple hepatic lesions whose nature is undetermined, and a liver biopsy would be warranted for further treatment plans. We believe this is the first functional study of bile excretion in biliary hamartomas using radionucleotide studies; such studies may have prognostic implications.展开更多
目的评价肝功能显像结合单光子发射型计算机断层显像(SPECT)技术对术后肝功能的预测价值。方法 20只新西兰白兔,随机平均分为肝纤维化肝癌组和正常组。两组均行肝脏右外叶切除术,术前1 d 行^(99m)Tc-二基乙酰苯胺亚氨二醋酸(^(99m)Tc-EH...目的评价肝功能显像结合单光子发射型计算机断层显像(SPECT)技术对术后肝功能的预测价值。方法 20只新西兰白兔,随机平均分为肝纤维化肝癌组和正常组。两组均行肝脏右外叶切除术,术前1 d 行^(99m)Tc-二基乙酰苯胺亚氨二醋酸(^(99m)Tc-EHIDA)肝脏显像,计算代表整体肝功能的5 min 心区清除指数(HCI_5)、5 min 心肝相关指数(HLI_5)、15 min 肝脏排泄率(Ex_(15)),结合SPECT 技术计算代表剩余肝功能的 HCI_(5p)、HLI_(5P)和 Ex_(15P),;术后4 d 重复^(99m)Tc-EHIDA 肝脏显像。术前1 d 和术后4 d 检测肝功能,包括丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(GGT)、总胆红素(TBil)、总蛋白(TP)、白蛋白(ALB)、胆碱脂酶(CHE)和白蛋白与球蛋白比值(A/G)。结果整体肝功能指标中,肝纤维化肝癌组 Ex_(15)低于正常组(P<0.05),肝纤维化肝癌组 HCI_5和 HLI_5较正常组有升高趋势(P>0.05);Ex_(15)与 ALB 成正相关、与 TBil 和 GGT 成负相关(P<0.05),HCI_5与 CHE 成正相关(P<0.05),HLI_5与 A/G 成负相关(P<0.05)。剩余肝功能指标中,HLI_(5P)与术后 A/G 成负相关(P<0.05),Ex_(15P)与 TBil 和 GGT 成负相关(P<0.05)。结论应用肝脏显像结合SPECT 技术可以在动物模型上建立三维立体肝功能评估方法,在获得的参数中,Ex_(15)可以定量评价整体肝功能,Ex_(15P)和 HLI_(5P)可以预测术后剩余肝功能。展开更多
文摘We report a 61-year-old asymptomatic man who had a hepatic lesion whose nature was undetermined, based on biochemistry, serology, ultrasonography, computed tomography, and magnetic resonance imaging studies. Biliary hamartomas were diagnosed by echo-guided needle biopsy. Functional studies of bile excretion, using 99mTc-diisopropyl iminodiacetic acid (99mTc-DISIDA) scintigraphy liver single-photon emission computed tomography (SPECT) showed the delayed transit of tracers from hepatocytes to the biliary hamartomas and the delayed emptying of tracers to the neighboring bile ducts. Therefore, biliary hamartomas should be included in the differential diagnosis of single or multiple hepatic lesions whose nature is undetermined, and a liver biopsy would be warranted for further treatment plans. We believe this is the first functional study of bile excretion in biliary hamartomas using radionucleotide studies; such studies may have prognostic implications.
