^(99m)Tc-NGA SPECT显像评估肝癌兔术后肝脏储备功能  

Evaluation of postoperative hepatic functional reserve using ^(99m)Tc-NGA SPECT imaging in an rabbit model with hepatic carcinoma

作　　者：陈静[1] 李建生[1] 荚卫东[1] 刘文斌[1] 程义壮 姚晓波 

机构地区：[1]安徽医科大学附属省立医院肝脏外科,合肥市230001 [2]安徽医科大学附属省立医院核医学科,合肥市230001

出　　处：《实用肝脏病杂志》2013年第3期238-240,共3页Journal of Practical Hepatology

基　　金：国家自然科学基金资助项目(编号:81172364);安徽省高校自然科学研究重点项目(编号:KJ2011A171);安徽省科技攻关项目(编号:12010402112)

摘　　要：目的探讨99m-锝标记的新半乳糖人血清白蛋白(99mTc-NGA)肝脏显像结合单光子发射型计算机断层显像(SPECT)扫描技术在动物模型术前评估术后肝脏储备功能的可能性。方法 35只新西兰大白兔被随机分为肝癌组(n=25)和正常组(n=10)。两组均行肝脏右外叶切除术。术前1天行99mTc-NGA肝脏显像结合SPECT检查,计算代表整体肝功能指标的清除指数(HH15)、受体指数(LHL15)、肝摄取率(LUR)和肝摄取密度(LUD),预测术后肝功能的肝摄取率(pLUR)和肝摄取密度(pLUD);术后第4天再次行99mTc-NGA SPECT显像,计算术后实际肝功能的肝摄取率(sLUR)和肝摄取密度(sLUD)。结果肝癌组99mTc-NGA在肝区达峰时间(Tpeak)为8.17±1.33s,显著长于正常组(6.05±1.55s,P<0.05);肝癌组LUR和LUD分别为0.45±0.06%和0.25±0.01%,显著低于正常组的0.61±0.02%和0.26±0.01%(P<0.05);肝癌组LUR分别与CHE和ALB呈正相关,与TBIL和GGT呈负相关(P<0.05),LUD与AST呈负相关(P<0.05);术前预测的肝功能指标pLUR和pLUD分别为0.49±0.02%和0.28±0.03%,而术后实际的肝功能指标sLUR和sLUD分别为0.45±0.06%和0.26±0.04%。分析发现pLUR与TBIL和GGT呈负相关(P<0.05),pLUR与sLUR呈正相关(P<0.05)。结论99mTc-NGA SPECT三维显像在动物模型上模拟肝切除,评估术后肝脏储备功能是可行的。LUR不但可用于评估整体肝功能,而且对术前评估术后肝脏储备功能也具有十分重要的价值。Objective To explore the feasibility of 99mTc-NGA combined with SPECT in the preoperative evaluation of postoperative hepatic functional reserve in rabbits.Methods 35 New Zealand white rabbits were randomly divided into hepatic carcinoma group（n=25） and control group（n=10）.Rabbits in both groups were underwent the resection of outer-right lobe of the liver,and liver function and coagulation index were detected.The whole hepatic function indexes,such as clearance index（HH15）,receptor index（LHL15）,liver uptake rate（LUR） and liver uptake density（LUD）,and predictive postoperative liver function indexes,including predictive liver uptake rate（pLUR）and predictive liver uptake density（pLUD） were calculated by 99mTc-NGA SPECT imaging.On 4th day after surgery,the actual postoperative liver function indexes,such as actual liver uptake rate（sLUR） and actual liver uptake density（sLUD）,were calculated by 99mTc-NGA SPECT.Results Peak time in liver（Tpeak） in hepatic carcinoma group（8.17±1.33s）was significantly higher than in the control group（6.05±1.55s,P0.05）;LUD and LUR in hepatic carcinoma group（0.45±0.06% and 0.25±0.01%）,were significantly lower than those in control group（0.61±0.02% and 0.26±0.01%,P0.05）;LUR in hepatic carcinoma group had a positive correlation with serum cholesterol and albumin,while a negative correlation was found with bilirubin and gamma glutamyl transferase,respectively（P0.05）;LUD had a negative correlation with aspartate transaminase（P0.05）;pLUR and pLUD were 0.49±0.02% and 0.28±0.03%,while postoperative liver function sLUR and sLUD were 0.45 ± 0.06% and 0.26±0.04%;a negative correlation between pLUR and serum bilirubin and gamma glutamyl transferase（P0.05）,and a positive correlation between pLUR and sLUR（P0.05）were found,respectively.Conclusions 99mTc-NGA SPECT three-dimensional imaging is feasible to predict liver function reserve after hepatectomy in an animal model.

关 键 词：肝脏手术 99mTc-新半乳糖人血清白蛋白 单光子发射型计算机断层显像 肝脏储备功能 

分 类 号：R735.7[医药卫生—肿瘤]