title: (99m)Tc-phytate trans-splenic portal scintigraphy in the diagnosis of cirrhotic portal hypertension and compensatory circulation.
abstract: OBJECTIVE
  The trans-splenic portal scintigraphy (TPS) was evaluated as a diagnostic tool in the post viral hepatitis cirrhotic patients of various classes of Child Pugh's (CP) classification. The main aim was to determine the portosystemic shunt index (PSSI) and to compare the results with various clinical grades of disease severity in liver cirrhosis.
  
  
  METHODS
  TPS was performed on 72 patients and 10 controls and PSSI was derived. All the 72 patients were categorized according to CP classification into three classes. The cirrhotic patients were categorized as CP A (n = 24),CP B (n = 22), and CP C (n = 26)according to CP criteria. PSSI was compared with different CP classes.
  
  
  RESULTS
  In the controlled population, the splenic vein was normal in shape and the mean PSSI was calculated to be 0.178 ± 0.031 (n = 10). For CP classes A, B, and C, the mean PSSI was 0.36 ± 0.04, 0.45 ± 0.05, and 0.54 ± 0.04 (n = 26), respectively. There was statistical significance among groups (p ≤ 0.01).The collateral vessels were mostly uphill or complex. The PSSI index increased as the CP score worsened from A to C.
  
  
  CONCLUSIONS
  PSSI is a useful and minimally invasive tool to detect and quantify the shunt severity, which correlates well with different clinical grades of disease severity.
authors: Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar, Pakistan, aakif_khan@yahoo.com.
authors: Aakif Ullah
authors: AU
authors: Khan
authors: Javaid
authors: J
authors: Irfanullah
authors: Syed Qaiser
authors: SQ
authors: Shah
authors: Shazia
authors: S
authors: Fatima
mesh_terms: D000328:Adult; D003097:Collateral Circulation / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000000981:diagnostic imaging*; D008099:Liver / Q000098:blood supply; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D010833:Phytic Acid; D011169:Portal Vein / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013667:Technetium
chemical_list: D019275:Radiopharmaceuticals; D013667:Technetium; D010833:Phytic Acid