Variants of Liver Location in Relation to the Cardiac Position on Resting Thallium-201 Myocardial SPECT

靜態鉈－201心肌灌注造影之肝與心臟相對位置變異

陳慶元(Ching-Yuan Chen) ； 施維貞(Wei-Jen Shih) ； 黃文盛(Wen-Sheng Hunag) ； 程紹智(Shiou-Chi Cherng)

《核子醫學雜誌》 19卷3期 (2006/09) Pp. 135-140

https://doi.org/10.6332/ANMS.1903.002

摘要

背景：常規鉈－201心肌灌注造影檢查時，原始影像資料常用來排除假影，因此，也可用來評估肝臟與心臓的相對位置。
方法：本研究共蒐集146位男性心臟造影的原始影像資料。造影時受檢者仰臥，以三個頭的加馬攝影機蒐集影像，再以三度立體空間呈現每一筆資料，以觀察肝臟與心臟相對位置，並比對同時間之胸部放射線檢查結果。肝臟變異區分為較大或較小的左肝葉、Chapeau de gendarme、Riedel lobe及垂直方向的肝葉、凹凸型、扁平型或球型的肝葉等八類。
結果：55位病患(37.7%)呈現高位型肝臟，48位(32.9%)較小左肝葉，41位(28.1%)扁平型肝臟，1位較大左肝葉及1位內凹型肝葉。在55位高位型肝臟病患中，有30位(54.5%)其同時間之胸部放射線檢查結果發現有右下肺擴張不全或慢性肺病，19位(34.5%)是左肺肋膜積水等疾病，因而造成右橫隔膜的上升；另有6位(10.9%)其右橫隔膜上升是由於Chapeau de gendarme型肝臟所致。氣胸及兩側肋膜積水可發現於所有的扁平型肝臟。
結論：心肌灌注造影原始影像資料一旦呈現高位或扁平型肝臟時，必須仔細檢查肺葉、肋膜及橫隔膜，看是否有例如肺擴張不全、氣胸或肋膜積水等異常。

關鍵字

鉈－201單光子射出電腦斷層心臟灌注造影 ； 原始影像資料 ； 肝臟位置變異 ； 高位型肝臟

並列摘要

Background: On a rest 201TI myocardial SPECT, raw data images are obligated to check possible artifacts during the imaging acquisition. Thus, they may also simultaneously assess the position of the liver and heart.
Methods: With the patients in a supine position, rest 201TI myocardial SPECT was acquired by a three-head camera in 146 male patients. Each patient's raw data images were viewed by a three-dimensional display to locate activity of the liver in relation to that of the heart. Variants of liver appearances were categorized as small left lobe, large left lobe, Riedel lobe, Chapeau de gendarme, and vertical orientation, concave, flat, and globular liver. The findings of variants of liver location were correlated with the available concurrent chest CT or radiography.
Results: Fifty-five patients (37.7%) had high position of the liver; 48 (32.9%) small left lobe; 41 (28.1%) flat liver; 1 (0.7%) large left lobe and 1 (0.7%) concave liver. Among those with high position of the liver, 30 patients had concurrent elevation of the right diaphragm due either to atelectasis or/and chronic changes of the right lower lobe of the lungs; 19 left pleural effusion, and 6 Chapeau de gendarme shape. Emphysema (35) or bilateral pleural effusion (6) accounted for the flat liver.
Conclusions: A high position of the liver and a flat liver on resting 201TI myocardial SPECT should lead to cause a search for lungs, pleura, and/or diaphragmatic abnormality such as pulmonary atelectasis, emphysema, or pleural effusion.

並列關鍵字

201TI myocardial SPECT ； raw data images ； variants of liver appearances ； high position of the liver