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Measurement of parenchymal function and bile duct flow in primary sclerosing cholangitis using dynamic 99m Tc‐HIDA SPECT
Author(s) -
JONAS EDUARD,
NÄSLUND ERIK,
FREEDMAN JACOB,
BEFRITS RAGNAR,
BLOMQVIST LENNART,
SIÖSTEEN ANNAKARIN,
JACOBSSON HANS,
HULTCRANTZ ROLF
Publication year - 2006
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2005.04084.x
Subject(s) - medicine , primary sclerosing cholangitis , bile duct , liver function , scintigraphy , parenchyma , gastroenterology , liver disease , radiology , nuclear medicine , pathology , disease
Background and Aim: Primary sclerosing cholangitis is a chronic cholestatic disease characterized by obliterative fibrosis of intrahepatic and/or extrahepatic bile ducts. The unpredictable clinical course of the disease can be relentless, leading to premature death in a large percentage of patients. Prognostic index formulas, the revised Mayo model being the most frequently used, have been developed to predict clinical course and prognosis. The aim of this study was to investigate the potential value of dynamic 99m Tc‐HIDA SPECT in patients with primary sclerosing cholangitis by correlating scintigraphic results with cholangiographic and biochemical findings and prognostic scoring systems used in clinical practice. Methods: In 18 patients with primary sclerosing cholangitis, segmental parenchymal and bile duct functions were measured using dynamic 99m Tc‐HIDA SPECT. Quantitative scintigraphic results were compared to cholangiographic findings, as graded by a biliary classification system, the Child–Pugh score and revised Mayo prognostic score, as well as the individual biochemical parameters included in the scoring systems. Results: In individual segments, scintigraphic quantitative parameters indicative of bile flow showed a statistically significant correlation with the state of the bile‐flow path for the respective segments as assessed by the biliary classification system. The revised Mayo score correlated with the scintigraphic quantitative parameters indicative of parenchymal function and bile flow as calculated for the whole liver. Conclusions: Dynamic 99m Tc‐HIDA SPECT, capable of assessing different aspects of liver function for the total liver, as well as for individual segments, has potential value in the management of patients with primary sclerosing cholangitis.