Clinical Observation of Liver Scintigram

간(肝) Scintigram의 임상적(臨床的) 고찰(考察)

Although primary application of radioisotope scanning technics to the liver has been of use in the detection of the intra-hepatic space occupying lesion from the normal functioning liver parenchyme, there has been on increasing awareness of its use in evalution of Liver function. In this study, the diseases of the liver were classified into group A,B,C and D by the liver scanning findings, conventional liver function tests and clinical findings. Following were the results: 1. The colloidal radiogold liver scan appeared normal in the group A, also the albumin in serum, alkaline phosphatase activity and prothrombin time were within normal levels in this group. 2. In the group B, there were acute hepatitis 24(48%), chronic hepatitis 5(10%), toxic hepatitis 3(6%), subacute hepatic necrosis 3(6%), typhoid liver 4(8%), hepatic tuberculosis 2(4%), diabetes mellitus 3(6%) and others 3(6%). In this group, SGOT and SGPT were increased predominantly as compared with group A, and the liver scan showed small amount of mottling of activity and faintly visualized spleen. 3. In the group C, there were postnecrotic liver cirrhosis 30(60%), Laennec cirrhosis 10(20%), cardiac cirrhosis 1(2%), cholangiocarcinoma 1(2%), chronic active hepatitis 6(12%), hepatic milliary tuberculosis 1(2%) and gall bladder cancer 1(2%). In this group, the albumin in serum and prothrombin time were lowered significantly and the liver scan showed severe mottling of activity with extra-hepatic uptake in the spleen and bone marrow along the vertebral column. 4. In the group D, there were primary hepatoma 26(52%), hepatoma with liver cirrhosis 7(14%), metastatic liver cancer 5(10%), liver abscess 10(20%), multiple liver cyst 1(2%) and cystic duct adenoma 1(2%), In this group, the alkaline phosphatase activity was elevated with single or multiple intrahepatic space occupying lesion in the radiogold colloid liver scan.