Scintigraphic study of regenerative nodules due to fulminant hepatic failure.
We report the case of a 25-year-old woman with fulminant hepatic failure (FHF). Liver scintigraphy using (99m)Tc-galactosyl human serum albumin (GSA) and (99m)Tc-phytate produced interesting findings; regenerative nodules appeared as nodules of increased accumulation of (99m)Tc-GSA, whereas these nodules were expressed as defects of accumulation of (99m)Tc-phytate. These scintigraphic findings suggested that the functions of hepatocytes in regenerative nodules were maintained, whereas those of Kupffer cells were impaired. Although (99m)Tc-GSA scintigraphy indicated hepatic functional reserve enough to survive, she died despite intensive therapy including plasma exchange. Based on this case, it is recommended that not only (99m)Tc-GSA scintigraphy but also (99m)Tc-phytate scintigraphy is required to evaluate the prognosis of patients with FHF.
Watanabe
Tomohiro
T
Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
Kondo
Masahiko
M
Hirasa
Masahiro
M
Shirane
Hirofumi
H
Okabe
Yoshihiro
Y
Ibuki
Yasuyoshi
Y
Tomita
Shusuke
S
Orino
Akio
A
Todo
Akio
A
Wakatsuki
Yoshio
Y
Chiba
Tsutomu
T
Kudo
Masatoshi
M
D000328:Adult; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D017093:Liver Failure / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008115:Liver Regeneration; D015609:Organotechnetium Compounds; D010833:Phytic Acid; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate
D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; C026177:technetium phytate; D010833:Phytic Acid; D016284:Technetium Tc 99m Pentetate