Alternative Semiquantitative Evaluation of Tc-99m MAA for Hepatopulmonary Syndrome

鎝-99m MAA掃描偵測肝肺症候群之替代性半定量評估

莊紫翎(Tzyy-Ling Chuang) ； 曾國枝(Kuo-Chih Tseng) ； 王昱豐(Yuh-Feng Wang)

《核子醫學暨分子影像雜誌》 28卷3期 (2015/09) Pp. 109-116

https://doi.org/10.6332/ANMMI.2803.002

摘要

目的：本篇研究旨在針對診斷肝肺症候群相關之有意義的右至左分流，建立鎝-99m macroaggregated albumin（Tc-99m MAA）掃描之替代性半定量評估方式。材料與方法：鎝-99m MAA掃描施行在一位以對比劑影像強化心臟超音波診斷肝肺症候群之病患。另有5位正常受試者接受同樣程序的鎝-99mMAA掃描；其中一位也接受對比劑影像強化心臟超音波，其為正常。還有一位因為藥物滲漏，做了兩次鎝-99m MAA掃描。我們根據醫學文獻報導及自己發展的莊氏法（Chuang's method）等多種半定量公式，來計算分流指數（shunt index）。結果：莊氏法在肝肺症候群之病患及正常人之間，顯示出顯著的差異；然而其他半定量法，無法區分這兩者。結論：在鎝-99m MAA掃描，莊氏半定量法更為簡單，且可能可以幫助診斷肝肺症候群。

關鍵字

肝肺症候群 ； 右至左分流 ； 分流指數 ； 鎝-99m MAA

並列摘要

Purpose: This study aimed to establish an alternative semiquantitative equation method of Tc-99m macroaggregated albumin (Tc-99m MAA) scanning for diagnosing hepatopulmonary syndrome (HPS) associated with significant right-to-left shunting. Materials and Methods: A Tc-99m MAA scan was performed in a patient with HPS who was diagnosed by contrast-enhanced echocardiography. Five normal subjects received Tc-99m MAA scan; one of them also received a contrast-enhanced echocardiogram which was normal. Another normal control received repeated scan due to injection loss from extravasation. We calculated the shunt index using several semiquantitative equations according to both the medical literature and our own developed Chuang's method. Results: Chuang's method showed significant differences between the HPS patient and normal subjects while other semiquantitative methods did not distinguish between the two categories. Conclusions: Chuang's semiquantitative method is simpler and may be helpful for diagnosing HPS with the Tc-99m MAA scan.

並列關鍵字

hepatopulmonary syndrome ； right-to-left shunt ； shunt index ； Tc-99m MAA