Improved scintigraphic assessment of severe cholestasis with the hepatic extraction fraction

David Lieberman, Paul Brown, Gerbail T. Krishnamurthy

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

In previous studies, we found that biliary scintigraphy with technetium-99m-labeled iminodiacetic acid ([99mTc]IDA) provided excellent discrimination between intrahepatic and extrahepatic cholestasis, except in patients with profound cholestasis who had poor visualization of the biliary tree. In this study, we have used deconvolution analysis to determine the hepatic extraction fraction (HEF) of a hypothetical single circulatory pass of[99mTc]IDA. Our hypothesis was that extraction of radionuclide from the blood would be normal in patients with extrahepatic obstruction alone, but would be impaired in patients with intrahepatic disease (IHD). The purpose of this study was to compare the HEF in patients with profound cholestasis (bilirubin≥3.0 mg/dl) due to either IHD or common bile duct obstruction (CBDO). Normal subjects (N=13) had an HEF of 100%. Patients with CBDO (N=13) had slightly reduced HEF values (92.8±3.2%) despite profound hyperbilirubinemia (6.1±1.0 mg/dl). Patients with IHD (N=23) had a markedly reduced HEF (43.1±4.1%) which was significantly lower than patients with CBDO and normal subjects (P

Original languageEnglish (US)
Pages (from-to)1385-1390
Number of pages6
JournalDigestive Diseases and Sciences
Volume35
Issue number11
DOIs
StatePublished - Nov 1990

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Cholestasis
Liver
Common Bile Duct
Extrahepatic Cholestasis
Intrahepatic Cholestasis
Intrahepatic Bile Ducts
Hyperbilirubinemia
Technetium
Biliary Tract
Radioisotopes
Radionuclide Imaging

Keywords

  • cholestasis
  • cirrhosis
  • common bile duct obstruction

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Improved scintigraphic assessment of severe cholestasis with the hepatic extraction fraction. / Lieberman, David; Brown, Paul; Krishnamurthy, Gerbail T.

In: Digestive Diseases and Sciences, Vol. 35, No. 11, 11.1990, p. 1385-1390.

Research output: Contribution to journalArticle

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