A study of trans-rectal portal scintigraphy for the diagnostic evaluation of portal hypertension with hepatic cirrhosis

The portal hypertension of hepatic cirrhosis was studied by 99mTc-MIBI trans-rectum imaging. The portal systemic circulation was evaluated by the heart-liver ratio (H/L ratio) and the portosystemic shunt index (SI). The H/L and SI in 12 normal cases were 0.145 +- 0.042 and 0.124 +- 0.029. Whereas in 18 patients with hepatobiliary diseases of non-cirrhosis were 0.207 +- 0.076 and 0.169 +- 0.051, and in 47 patients with hepatic cirrhosis were 0.751 +-0.313 and 0.422 +- 0.075. The results showed significant difference (P<0.01) between normal controls and non-cirrhosis group, and significant difference (P<0.001) between hepatic cirrhosis group and normal controls, non-cirrhosis group. A significant difference (P<0.05) in child-pugh's classification A, B and C groups was also found. A significant correlation (r = 0.95, P<0.01) with the H/L, SI and portal pressure measurement during operation was found. If H/L≥0.30, and SI≥0.22 were taken as positive criteria for diagnosis of portal hypertension with hepatic cirrhosis, the sensitivity, specificity and accuracy were 96%, 90% and 94% respectively. Therefore, it was a new method for the diagnosis of portal hypertension with hepatic cirrhosis