Staging of portal hypertension and portosystemic shunts using dynamic nuclear medicine investigations.

Aim: To explore portal hypertension and portosystemic shunts and to stage chronic liver disease (CLD) based on the pathophysiology of portal hemodynamics.

Methods: Per-rectal portal scintigraphy (PRPS) was performed on 312 patients with CLD and liver angioscintigraphy (LAS) on 231 of them. The control group included 25 healthy subjects.

Nuclear medicine dynamic investigations of diffuse chronic liver diseases and portal hypertension.

Radio-isotopic techniques may be useful in diagnosis and staging of chronic diffuse liver diseases. Liver angioscintigraphy (LAS) and per-rectal portal scintigraphy (PRPS) are at well discriminating portal hypertension (PHT), very early cirrhosis hemodynamic failure and compensatory arterialisation of liver perfusion. Supplied information is related to PHT, liver morphology and mesenchimal activity in liver, spleen and bone marrow.

Liver angioscintigraphy: clinical applications.

Liver angioscintigraphy (LAS) is a radio-isotope method for the investigation of liver perfusion and its alteration in various hepatic diseases. It measures the arterial and portal venous fractions of total liver blood flow. The percentage of liver blood flow supplied by hepatic artery is estimated mathematically by the hepatic perfusion index (HPI), normally between 25 % and 40 %.

[The determination by computed scintigraphy of the evacuation time of the resected stomach under the administration of salbutamol and dopamine].

The evacuation time (T1/2) of the stomach was determined in the patients with partial gastric resection by a sequential computerized scintigraphic method. The effect of Salbutamol and Dopamine was followed on T1/2 and the scintigraphic surface of the stomach (appreciated indirectly by measuring the longitudinal and transversal diameters). Salbutamol prolongs significantly T1/2, from 6.

The clearance of colloidal particles by Kupffer cells in collagen disease.

The Kupffer cells clearance of colloidal 198Au particles with a diameter of 200-300 A was estimated in 14 subjects with different collagen diseases: 7 without previous treatment and 7 under immunodepressive treatment compared to 10 controls. No difference between the subjects with collagen disease and controls was observed. The group with collagen disease under immunodepressive treatment has lower Kupffer cells clearance for colloidal gold particles than non-treated patients, without statistical significance.

[Our experience in testing the lacrimal drainage system using radionuclides (nuclear dacryocystography with 99mTc O4)].

The function of the lacrimal drainage system was tested in 5 patients and 3 controls by scintigraphy with a Pho-GAMMA HP-1206 Nuclear scanner Chicago, coupled with a visualization system and data processing device of type MB 9101-GAMMA.

Gastric sequential scintigraphy. Methodology with liquid isotonic meal.

The radioisotopic measurement of gastric emptying offers information about an aspect of gastric motility. A procedure performed in our laboratory is presented. It is based on the ingestion of 500 ml saline including 1 mCi (3.

Delayed gastric emptying in rx-negative dyspepsia.

In 9 out of 11 subjects with upper digestive dyspepsia: pyrosis, nausea, emesis, bloating, with negative roentgenological findings, a radioisotopic test detected a delayed gastric emptying. The investigation was based on a 500 ml saline meal including lmCi (3.7 MBq) 113m In-DTPA.

Colchicine treatment effects on liver cirrhosis assessed by liver blood flow measurements.

Hepatic fibrosis is common in all chronic liver diseases. This fibrosis induces morphological, functional and hemodynamic changes. Among the antifibrotic drugs, colchicine gave the most encouraging results.

The gastric 99mTc clearance--a technique for the evaluation of the gastric blood flow.

The gastric mucosa blood flow was investigated using the 99mTc clearance. Besides the clearance the "R" ratio, total radioactivity of the gastric juice and the volume of gastric juice (ml/15 min) were also investigated. The main characteristics of the method are its reproducibility and the parallelism existing between: clearance, the "R" ratio and total radioactivity.

Liver blood flow (LBF) estimated by Kupffer cells clearance in health and disease.

Liver blood flow (LBF) in normal state and in diseases suspected to impair liver perfusion has been estimated by an indirect method, based on the removal by Kupffer cells of the colloidal particles from the circulation. 150 microCl 198Au have been used and the results have been expressed through percentual decrease from the theoretical value. In chronic liver disease there is a progressive reduction of the Kupffer cells clearance and of the LBF corresponding to the severity of the liver impairment.

[Contribution of sequential scintigraphy with 131I-BSP to the differential diagnosis of jaundice (author's transl)].

Patients with constitutional hyperbilirubinemia and with extra intrahepatic cholestasis have been explored by means of sequential scintigraphy, with the following results: 1. in Gilbert's syndrome liver uptake and output of 131I-BSP were normal; 2. in the Dubin-Johnson syndrome liver uptake and plasma clearance of 131I-BSP were normal; the substance was retained for a long period (2 hrs) in the liver without any tendency to be excreted; 3.

[Electronic data processing of liver scintigrams in chronic hepatitis (author's transl)].

Following administration of 150 muCi of colloidal 198Au numerical scintigrams of the liver and the spleen were obtained in about 200 patients with various forms of chronic hepatitis or with liver cirrhosis as well as in 24 control persons. The data so obtained were electronically processed and the relative activities of the liver, the spleen and both liver lobes compared. Differences of diagnostic value were observed between the various stages of chronic hepatitis.