Blood volume distribution in patients with cirrhosis: aspects of the dual-head gamma-camera technique.
OBJECTIVE
Patients with cirrhosis have increased total blood volume (TBV). The size of the "effective" blood volume has been closely investigated, whereas the distribution of the blood volume outside the thorax has not been examined. The aim was to estimate the blood volume distribution in patients with cirrhosis and portal hypertension, using a dual-head gamma-camera technique (DHGCT) and to validate this technique.


METHODS
Twenty-three patients with cirrhosis, 11 non-cirrhotic control patients, and six healthy controls had their blood volume distribution determined by the DHGCT.


RESULTS
The close relation between the estimated blood volume in the thorax region and the central and arterial blood volume, obtained by the dynamic indicator dilution technique (r=0.87, P<0.001), indicates validity of the DHGCT. Whole-body scintigraphy showed altered blood volume distribution in the cirrhotic patients with increased splanchnic blood volume (SpBV: 25.0 vs. 18.2% of TBV in controls, P<0.001), and all but one patient with hepatic venous pressure gradient above 12 mmHg had SpBV above 20% of TBV, but the blood volumes in the liver region were similar.


CONCLUSIONS
DHGCT is a valid method of estimating the blood volume distribution. Patients with cirrhosis and portal hypertension have grossly increased blood pooling in the splanchnic region, indicating splanchnic congestion.
Kiszka-Kanowitz
M
M
Department of Gastroenterology, Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark.
Henriksen
J H
JH
Møller
S
S
Bendtsen
F
F
D001810:Blood Volume; D002560:Cerebrovascular Circulation; D005260:Female; D015902:Gamma Cameras; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000493:pharmacokinetics; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012016:Reference Values; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000493:pharmacokinetics; D013152:Splanchnic Circulation; D014018:Tissue Distribution
D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D012709:Serum Albumin; C107869:technetium Tc 99m serum albumin