Single injection hepatic radionuclide angiography and hepatobiliary scintigraphy in the evaluation of liver transplant function.

BACKGROUND

The aim of the study was the evaluation of the perfusion, morphology and biliary three patency of liver transplants employing two radionuclide methods.

MATERIAL AND METHODS

The study was performed on 10 controls and 10 patients after an orthotopic transplantation (up to two years). "First pass" dynamic acquisition was performed with a scintillation camera, after a bolus injection of 360 MBq 99mTc-diethyl- IDA, (60 frames/60s), continued by a 59 minute (1 frame/min) slower dynamic study. From the liver and kidney activity during the "first pass" study, the hepatic perfusion index (HPI) was calculated using slope-analysis. Hepatobiliary scintigrams obtained during second phase of the study were analyzed for morphology, and parenchymal and hepatobiliary TA curves were generated and analyzed according to the time to maximal activity (Tmax) and the time to half of maximum activity (T/2).

RESULTS

In comparison to the controls (HPI, X = 0.64.5 +/- 0.05%) portal perfusion had slightly (X = 0.68 +/- 0.04%), but not significantly (p > 0.05) increased. In 3 patients, the biliary phase of hepatobiliary scintigraphy showed an increased accumulation of the radiopharmaceutical in the left (n = 1) or right (n = 2) hepatic duct. The uptake of the radiopharmaceutical (Tmax, X = 18.5 +/- 2.9 min) was slightly, but not significantly (p > 0.05) delayed in comparison to the controls (X = 14.2 +/- 3.4 min), while excretion was significantly (p < 0.05) prolonged (X = 59.5 +/- 12.1 min) (X = 34.2 +/- 4.1 min). Intrahepatic bile flow was insignificantly (p > 0.05) prolonged (X = 31.3 +/- 3.7 min) in comparison to the controls (X = 25.7 +/- 3.5 min) while extrahepatic bile flow was high, significantly (p < 0.01) prolonged (X = 89.0 +/- 14.3 min) than physiological one (X = 45.0 +/- 7.2 min).

CONCLUSIONS

Radionuclide methods are noninvasive, sensitive and valuable in monitoring liver transplants.