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Background. Technetium 99m diethylenetriaminepentaacetic acid-galactosyl-human serum albumin
(99mTc-GSA) is a new liver scintigraphy agent that binds to the asialoglycoprotein receptors.
We evaluated the clinical use of 99mTc-GSA for the perioperative assessment of hepatectomy.
Methods. Thirty-six patients with hepatocellular carcinoma were admitted for elective hepatectomy.
99mTc-GSA scintigraphy was obtained after the intravenous injection of 99mTc-GSA, and a modified receptor index (MRI) was calculated. 99mTc-GSA scintigraphy, conventional liver function, the plasma disappearance rate, and
the 15-minute retention rate of indocyanine green (ICGR15) were carried out before
operation and every 1 to 3 months after operation. The relationships between several
systemic hemodynamic parameters, histologic activity index (HAI), plasma disappearance
rate, and ICGR15 or MRI values were estimated.
Results. A significant correlation was obtained between the MRI and ICGR15 (r=0.6231, p<0.001).
Plasma disappearance rates correlated well with systolic volume and left cardiac work,
whereas MRI values did not correlate with these systemic hemodynamics. Preoperative
discrepancies between the values of MRI and ICGR15 were seen in eight cases. In these
cases the MRI values correlated well with HAI scores (p<0.05) but there was no significant
correlation between ICGR15 values and the HAI scores.
Conclusions. These results suggested the use of 99mTc-GSA scintigraphy as a easy and reliable method for determining liver functional
reserve.
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Article info
Publication history
Accepted:
August 30,
1994
Identification
Copyright
© 1995 Mosby-Year Book, Inc. Published by Elsevier Inc.
