title: Analysis of liver single photon emission computed tomography in a case of fulminant hepatic failure.
abstract: Fulminant hepatic failure is associated with a high mortality rate. Thus, accurate assessment of hepatic functional reserve and hepatic regeneration is important. We describe a 67-year-old woman who survived subacute hepatic failure. We had an opportunity to monitor the clinical course of the patient using single photon emission computed tomography (SPECT) with 99mTc-galactosyl-human serum albumin (99mTc-GSA) and frequent hematological examinations. On admission, prothrombin time was remarkably prolonged (23.1% of control). The liver uptake of 99mTc-GSA was also considerably low. She responded well to treatment. Four weeks after admission, SPECT analysis showed a dramatic increase in liver uptake of 99mTc-GSA, suggesting promotion of hepatic regeneration. Moreover, functional liver volume calculated from the SPECT data showed a marked increase at 4 weeks after admission, whereas CT scan showed no change at that point. This indicated that SPECT with 99mTc-GSA reflected functional hepatocytes more accurately than liver volume determined by CT scan, which cannot exclude nonfunctional hepatocytes. The patient's condition improved in parallel with the improvements in the indices measured by SPECT and hematological examinations. SPECT analysis is practically useful for the prompt assessment of improvement in patients with fulminant hepatic failure.
authors.affiliation: The Second Department of Internal Medicine, Yamagata University School of Medicine, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Sugahara
authors.forename: H
authors.initials: H
authors.lastname: Togashi
authors.forename: H
authors.initials: H
authors.lastname: Shinzawa
authors.forename: T
authors.initials: T
authors.lastname: Matsuo
authors.forename: Y
authors.initials: Y
authors.lastname: Takeda
authors.forename: S
authors.initials: S
authors.lastname: Miyano
authors.forename: H
authors.initials: H
authors.lastname: Haga
authors.forename: K
authors.initials: K
authors.lastname: Saito
authors.forename: T
authors.initials: T
authors.lastname: Saito
authors.forename: Y
authors.initials: Y
authors.lastname: Onodera
authors.forename: K
authors.initials: K
authors.lastname: Takahashi
authors.forename: Y
authors.initials: Y
authors.lastname: Sugai
authors.forename: H
authors.initials: H
authors.lastname: Saito
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017093:Liver Failure / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon