[Estimation of portosystemic shunt by transrectally administered 123I-IMP]

Portosystemic shunt index was estimated in 7 patients without liver disease and 95 patients with various liver diseases by portal scintigraphy with transrectally administered 123I-iodoamphetamine (IMP). The shunt index was 0% in patients without liver diseases, 5.3% in acute hepatitis, 5.9% in chronic inactive hepatitis, 11.4% in chronic active hepatitis, 56.6% in compensated liver cirrhosis and 88.1% in decompensated liver cirrhosis. The shunt index was significantly higher in liver cirrhosis, especially decompensated stage. In 5 of 9 patients with acute hepatitis, shunt index was 0%. In 3 of remaining 4 patients with elevated shunt index, shunt index became 0% within 1-2 months. Significant relationship was observed between the shunt index and hepatic function tests such as ChE, albumin, gamma-globulin and ICG-R15. These results suggest that the shunt index is independent of hepatic cell necrosis and reveals the shunted blood flow exactly. Therefore, this technique is useful for evaluating the portosystemic shunt in various liver diseases.