Assessment of portal vein shunt with 99mTc-RBC

The authors report the methodology of 99mTc-RBC in the assessment of portal vein shunt with the aim to predict the occurrence of hepatic encephalopathy and esophageal varicosity. Three parameter differences in cardiac and hepatic imaging time, liver shunt index (SI) and heart/liver radioactive ratio(H/L) were used to assess the establishment of portal vein shunt and to evaluate its degree. Normal SI was 6.39 +- 1.13, H/L ratio 0.101 +- 0.016. In chronic hepatitis, SI was 12.12 +- 3.23, H/L 0.225 +- 0.112. In liver cirrhosis, SI was 55.56 +- 21.80, H/L 2.623 +- 2.297. In primary biliary cirrhosis, SI was 64.50 +- 6.61, H/L 3.65 +- 1.10. In idiopathic portal hypertension, SI was 8.1, H/L 7.7. Thirty cases of cirrhosis were categorized as A, B, C conforming to Child-Pagh's classification. In the 3 groups H/L exhibited significant difference (P<0.01). It was concluded that this method can be used to assess the presence of shunt in patients with cirrhosis, and also to evaluate its degree. Furthermore, it can be applied to the staging and surveying the result of treatment