99Tcm-EHIDA肝胆动态显像判断肝硬化患者胆囊运动功能

目的研究^99Tc^m-二乙基乙酰苯胺亚氨二醋酸（EHIDA）肝胆动态显像在判断肝硬化患者胆囊运动功能中的作用.方法研究对象分为正常对照组和肝硬化组,其中肝硬化组分为胆石组和非胆石组.受试者均行^99Tc^m-EHIDA肝胆动态显像.获得图像后应用胆囊感兴趣区（ROI）技术,由计算机自动绘制胆囊时间-放射性曲线,并计算潜伏期（LP）、排胆期（EP）、排胆分数（GBEF）和排胆率（ER）.结果肝硬化组患者GBEF和ER明显低于正常对照组（t值均为2.767,P均＜0.01）,但其LP高于正常对照组（Z=-1.989,P＜0.05）.肝硬化胆石组胆囊运动异常率（x^2=4.538,P=0.033）、胆囊壁厚度（t=-2.386,P=0.02）和血清总胆汁酸（t=-2.442,P=0.018）明显高于非胆石组.结论肝硬化患者胆囊运动功能减弱.^99Tc^m-EHIDA肝胆动态显像可作为检查胆囊运动功能的一种无创、准确的方法.

The role of 99Tcm-EHIDA hepatobiliary scintigraphy in the estimation of gallbladder motility in patients with liver cirrhosis

Objective To investigate the role of ~(99)Tc~m-2,6-diethylace tanilide-iminodiacetic acid (EHIDA)hepatobiliary scintigraphy in the estimation of gallbladder motility in patients with liver cirrhosis. Methods Liver cirrhosis subjects and normal subjects were included.Patients were further divided into two groups:gallstones group and no gallstone group.Serial hepatobiliary images were taken for 65 min at 1-mi- nute intervals.Two regions of interest(ROIs)were chosen:RO11,over the entire gallbladder;ROI2,over the entire liver,and time-activity curves were generated for both regions.And then latent period(LP),e- jection period(EP),gallbladder ejection fraction(GBEF)and ejection rate(ER)were calculated.Re- sults Significant differences in GBEF,LP and ER were found between 14 normal subjects and 58 cirrhosis patients.Significant differences in incidence of gallbladder motility abnormality,thickening of gallbladder wall and serum total bile acid(TBA)were found between 15 cirrhosis patients with gallstones and 47 with- out gallstone.Conclusions The gallbladder motility function of cirrhosis patients is impaired with tbe char- acteristic of impairment of GBEF and ER.~(99)Tc~m-EHIDA hepatobiliary scintigraphy is a noninvasive,safe and valuable method in the diagnosis of gallbladder motility dysfunction in cirrhosis patients.