[The arterial contribution to total liver perfusion (author's transl)]

Dynamic hepatic scintiangiography is a method of estimating some aspects of liver hemodynamics. Especially in cirrhotics and in liver-grafted patients this method may be clinically useful. We studied some methodological aspects of the differentiation between the arterial and the portal positions of the liver time activity curve. In 16 patients with otherwise proven pure arterial perfusion of the liver there wee three different forms of the curve: in 8 cases the first peak was followed by a second upslope. In 5 cases there was a plateau after the peak, and in 3 cases the peak was followed by a downslope of the curve. No general description of all curves could be found. Therefore all methods using plateau techniques for subtracting the arterial from the portal portion of the curve seem to be doubtful. In these and in other patients five different techniques were compared: the arterial part was much underestimated by the method of George (76 +/- 9%), slightly underestimated by the method of Biersack (91 +/- 8%), and much overestimated by the method of Boyd (123 +/- 11%). The methods of Fajman and our modification estimated always 100% in the patients with pur arterial perfusion. Comparing a set of independent evaluations the mean deviation wa 11% in normals and 23% in cirrhotics of arterial part. Only rough changes of the arterial to portal ratio of hepatic perfusion can be evaluated by dynamic hepatic scintiangiography.