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[99mTc-MIBI used for diagnosis of portal hypertension: an experimental study]
Abstract:
The authors investigated the relationship between portal-systemic shunting and portal pressure in 16 CCl4-induced cirrhotic wistar rats by 99mTc-MIBI photography of heart and liver. Based on radio-counts taken at 30 minutes after 99mTc-MIBI was given per rectum 8 rats or medial clonic vein 8 rats, heart radio-counts/liver radio-counts (H/L) and portal-systemic shunting index (SI) were recorded. It was shown that 1. H/L and SI of the two cirrhotic groups were greater than those of normals (P < 0.001); 2. H/L in cirrhotic rats by rectum 99mTc-MIBI administration was more closely related to free portal pressure (FPP, r = 0.83, P < 0.01) than in those by venous route (r = 0.74, P < 0.05) and its regressive formation FPP (kPa) = 0. 24 + 4.06 (H/L) was deduced and used to calculate portal pressure of cirrhotic rats. The very good relationship between the calculated and measured portal venous pressure was shown in a group of 12 cirrhotic rats (r = 0.85, P < 0.01). These findings suggested that the rectum administration of 99mTc-MIBI may be a useful method in calculating portal pressure and portal-systemic shunting in portal hypertensive patients.
Insights
Rectal administration of 99mTc-MIBI in cirrhotic rats effectively calculates portal pressure and portal-systemic shunting. This method shows a strong correlation with direct measurements, offering a potential non-invasive diagnostic tool.
Area of Science:
- Medical Imaging
- Hepatology
- Radiopharmacology
Background:
- Portal hypertension is a serious complication of liver cirrhosis.
- Accurate assessment of portal pressure and portal-systemic shunting is crucial for managing patients with portal hypertension.
- Current methods for measuring portal pressure can be invasive.
Purpose of the Study:
- To investigate the relationship between portal-systemic shunting and portal pressure in cirrhotic rats.
- To evaluate the efficacy of rectal 99mTc-MIBI administration for calculating portal pressure and shunting.
- To establish a non-invasive method for assessing portal hemodynamics.
Main Methods:
- 16 Wistar rats with CCl4-induced cirrhosis were studied.
- 99mTc-MIBI was administered rectally or via the medial clonic vein.
- Radio-counts of heart and liver were measured 30 minutes post-administration to calculate heart radio-counts/liver radio-counts (H/L) and shunting index (SI).
- Free portal pressure (FPP) was measured and correlated with H/L ratios.
Main Results:
- Both H/L and SI were significantly higher in cirrhotic rats compared to normal rats (P < 0.001).
- Rectal 99mTc-MIBI administration showed a stronger correlation between H/L and FPP (r = 0.83, P < 0.01) than the venous route (r = 0.74, P < 0.05).
- A regression formula was derived to calculate FPP from H/L, which demonstrated a strong correlation (r = 0.85, P < 0.01) with measured portal venous pressure in a separate group of cirrhotic rats.
Conclusions:
- Rectal administration of 99mTc-MIBI is a promising method for estimating portal pressure in cirrhotic rats.
- This technique may serve as a valuable non-invasive tool for assessing portal-systemic shunting and portal pressure in patients with portal hypertension.