Fulminant hepatic failure monitored by technetium-99m-DTPA-galactosyl-human serum albumin scintigraphy.
We describe a 43-yr-old woman with fulminant hepatic failure whose progress was monitored scintigraphically using 99m-Tc-galactosyl-human serum albumin (99mTc-GSA). On admission, the liver was atrophic and the heart was delineated distinctly by scintigraphy with 99m-Tc-GSA. The receptor index, calculated by dividing the radioactivity of the liver region of interest by the radioactivity of the liver plus heart regions of interest at 15 min post-tracer injection, was very low. As the patient's condition improved, the right lobe of the liver enlarged while the left lobe became atrophic; after 4 mo, the left lobe almost completely disappeared. Delineation of the heart gradually became less distinct, and the receptor index slowly increased. Hepatic receptor imaging with 99m-Tc-GSA can define both the hepatic functional reserve and morphological changes of the liver, so it is useful for the diagnosis and follow-up study of fulminant hepatic failure.
Shiomi
S
S
Third Department of Internal Medicine, Osaka City University Medical School, Japan.
Kuroki
T
T
Enomoto
M
M
Ueda
T
T
Masaki
K
K
Ikeoka
N
N
Takeda
T
T
Kobayashi
K
K
Ochi
H
H
D000328:Adult; D037263:Asialoglycoprotein Receptor; D001284:Atrophy; D002352:Carrier Proteins / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D005690:Galactose / Q000032:analysis; D006321:Heart / Q000000981:diagnostic imaging; D006501:Hepatic Encephalopathy / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000737:chemistry / Q000000981:diagnostic imaging / Q000473:pathology; D011877:Radionuclide Imaging; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D013997:Time Factors
D037263:Asialoglycoprotein Receptor; D002352:Carrier Proteins; D013668:Technetium Tc 99m Aggregated Albumin; C027122:hepatic sialoglycoprotein receptor; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate; D005690:Galactose