Preoperative assessment of residual hepatic functional reserve using 99mTc-DTPA-galactosyl-human serum albumin dynamic SPECT.

摘要: Preoperative assessment of residual hepatic functional reserve offers important strategic information for resection. To predict the postoperative liver function, we assessed value 99m Tc-diethylenetriamine pentaacetic acid-galactosyl-human serum albumin ( Tc-GSA) clearance estimated by dynamic SPECT analysis. Methods: We investigated 114 consecutive patients with disease, including 55 hepatectomy cases. One minute after injection 185 MBq Tc-GSA, 15 serial images were obtained every minute. The initial five sets analyzed Patlak plot to estimate sequential Tc-GSA (mL/min) as an index function. sum segments immune from resection was categorized predicted clearance. In cases, scintigraphy performed before and 37 ±10 d operation. Results: Good correlation observed between total conventional function tests: plasma retention rate iodocyanine green (ICG) at min (ICG R15), r = -0.600, P < 0.0001, n 94; disappearance ICG (K ICG), 0.670, 83; cholinesterase, 0.539, 121; albumin, 0.421, 123; hepaplastin test, 0.456, 120. There good in who underwent segmentectomy or lobectomy (r 0.84, 28) pre- subsegmentectomy 0.91, 25). Five had complications due insufficiency (2 died failure within 2 mo operation) showed significantly lower compared without (90.3 ± 37.2 versus 320.9 158.8 mL/min; 0.005). Conclusion: reflected addition, preoperative a indicator early prognosis. is assumed be useful method determining surgical strategy tumor especially dysfunction.