Nontumorous decrease in Tc-99m GSA accumulation.
Nontutimorous decrease in 99mTc-GSA accumulation has not been well covered in the literature. Understanding of this phenomenon is, however, essential for accurate evaluation of regional hepatic function. Scintigrams (transaxial SPECT) of 269 patients who underwent 99mTc-GSA liver scintigraphy were reviewed for the presence of nontumorous decreases in 99mTc-GSA accumulation. Nontumorous decreases in 99mTc-GSA accumulation were seen in 32 of 269 patients (12%). In 16 of the 32 patients (6%), nontumorous decreases in 99mTc-GSA accumulation corresponded to regional decrease in portal venous flow. The causes of such decrease in portal venous flow were portal thrombus of hepatocellular carcinomas in eight patients, portal venous stenosis or occlusion by hilar cholangiocarcinomas in five patients, inter alia. In eight patients (3%), the regions with decreased 99mTc-GSA accumulation correlated with massive hepatic necrosis in fulminant hepatitis, scar in hepatitis, or confleuent in portal venous flow, lobar biliary stasis, or both. In four patients (1.5%), the exact causes of nontumorous decrease in 99mTc-GSA accumulation could not be determined.
Akaki
S
S
Department of Radiology, Okayama University Medical School, Japan. akaki@cc.okayama-u.ac.jp
Kanazawa
S
S
Tsunoda
M
M
Okumura
Y
Y
Togami
I
I
Kuroda
M
M
Takeda
Y
Y
Hiraki
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000503:physiopathology; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology*; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals / Q000097:blood / Q000493:pharmacokinetics; D013668:Technetium Tc 99m Aggregated Albumin / Q000097:blood / Q000493:pharmacokinetics; D016284:Technetium Tc 99m Pentetate / Q000097:blood / Q000493:pharmacokinetics; D014018:Tissue Distribution; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate