A study of colloidal scintigraphy in alcoholic liver diseases: discordance from asialo-scintigraphic findings.
BACKGROUND
Our study was undertaken to check the discordance between findings from 99mTc-Sn colloidal reticuloendothelial scintigraphy (RESS) and 99mTc-GSA asialo-scintigraphy (GSA, a technique for evaluation of liver parenchymal cell density and function) and to analyze the discordance in relation to functional disturbances. We compared data between patients with alcoholic liver diseases (ALD) and patients with viral liver diseases (VLD).


METHODS
The subjects of this study were 40 patients with chronic liver disease (17 with ALD and 23 with VLD). We used the liver uptake ratio of the tracer of the Sn colloid (SnL15, %), the liver uptake rate (GSAL15, %), and the Rmax (an indicator of total liver receptors) as indices of liver scans.


RESULTS
GSAL15 was sometimes nondiscordant from SnL15. The patients were divided into two groups: the nondiscordant group (26 cases where the balance/sum of the two variables was <25%) and the discordant group (14 cases where the balance/sum was > or =25%). SnL15 was 41.6 +/- 16.2% in the nondiscordant group and 42.7 +/- 16.3% in the discordant group (p = 0.80). GSAL15 was 34.3 +/- 12.1% in the nondiscordant group and 21.5 +/- 8.1% in the discordant group (p = 0.001). Rmax was 0.33 +/- 0.17 in the nondiscordant group and 0.113 +/- 0.008 in the discordant group (p = 0.002). Thus, the SnL15, as determined by RESS, did not differ significantly between the nondiscordant and discordant groups, whereas GSAL15 was significantly unfavorable in the discordant group as compared with the nondiscordant group. SnL15 as determined by RESS did not differ significantly between the ALD group (40.4 +/- 18.7%) and the VLD group (43.5 +/- 15.0%) (p = 0.59), whereas Rmax as determined by GSA was significantly improved in the ALD group (0.34 +/- 0.20) compared with the VLD group (0.20 +/- 0.4) (p = 0.02).


CONCLUSIONS
Liver cell function was lower in cases that showed discordance between liver cell function and reticuloendothelial function compared with cases without such discordance, although reticuloendothelial function did not differ between discordant and nondiscordant groups. Liver cell function was better in cases of ALD than in cases of VLD, whereas reticuloendothelial function did not differ between the ALD group and the VLD group.
Koreeda
C
C
Third Department of Internal Medicine, Kansai Medical University, Moriguchi, Osaka, Japan.
Kawa
S K
SK
Takasu
M
M
Satoh
M
M
Takemoto
H
H
Mizuno
T
T
Sawada
S
S
Inoue
K
K
D000328:Adult; D000368:Aged; D037263:Asialoglycoprotein Receptor; D003102:Colloids; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000503:physiopathology / Q000821:virology; D008108:Liver Diseases, Alcoholic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012157:Mononuclear Phagocyte System / Q000503:physiopathology; D011877:Radionuclide Imaging; D011956:Receptors, Cell Surface / Q000378:metabolism*; D017556:Technetium Compounds; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D017971:Tin Compounds
D037263:Asialoglycoprotein Receptor; D003102:Colloids; D011956:Receptors, Cell Surface; D017556:Technetium Compounds; D013668:Technetium Tc 99m Aggregated Albumin; D017971:Tin Compounds; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; C033493:technetium Tc 99m tin colloid; D016284:Technetium Tc 99m Pentetate