Prognostic value of thallium-201 per rectum scintigraphy in alcoholic cirrhosis

In a 4-yr survival study, the prognostic value of the inferior mesenteric shunt, as evaluated by 201Tl per rectum scintigraphy, was assessed in 170 alcoholic cirrhotic patients. The global severity of the hepatic disease was assessed by the Child score, and specific hepatocellular function was evaluated by the aminopyrine breath test. Using 201Tl scintigraphy, three groups were considered: group I, heart-liver activities ratio (H/L ratio) < or = 0.5, n = 55; group II, H/L between 0.5 and 0.85, n = 50; and group III, H/L > 0.85, n = 65.

The 4-yr survival rates in the three groups were 76%, 36% and 18%, respectively. The log-rank test showed that the differences between the groups were statistically significant. Regression analysis using Cox's proportional-hazards model showed that the three parameters, Child score, aminopyrine breath test results and H/L ratio were significantly related to survival.

The inferior mesenteric shunt per se has a prognostic value in alcoholic cirrhosis. Moreover, the H/L ratio provides additional information on survival after the Child score and the aminopyrine breath test results have been taken into account.