肝胆显像( hepatobiliary scintigraphy )
DESCRIPTION
Bingxiu Ren Department of Nuclear Medicine,the first affiliated hospital of Kunming Medical University Mar.31,2014. 肝胆显像( Hepatobiliary scintigraphy ). Bingxiu Ren, PhD, attending doctor. Mayjor in nuclear imaging & therapy. Email:[email protected] Phone: +86 13529168551. 显像原理. - PowerPoint PPT PresentationTRANSCRIPT
Bingxiu RenDepartment of Nuclear Medicine,the first affiliated hospital of Kunming Medical
UniversityMar.31,2014
肝胆显像( Hepatobiliary scintigraphy )
Bingxiu Ren, PhD, attending doctor.
Mayjor in nuclear imaging & therapy.
Email:[email protected]
Phone: +86 13529168551
显像原理放射性示踪剂( radiotracers ) 肝细胞摄取 分
泌至胆汁 排泄至肠道 .
Ideal agents exihibit high extraction efficiency by live
r,rapid transit, and high concentration in bile.
: radiotracer:胆汁
肝胆系统图
胆红素肠肝循环及肝胆动态显像原理示意图
Radiopharmaceuticals (放射性药物)• 99mTc-imniodiactic acid(IDA): 可与胆汁均匀混合,
早期常用,但图像质量易受血液中总胆红素浓度的影响 .
• 99mTc-MIBI can be up taken and secreted by hepato
cytes, often used without concerning the TBIL level.
Normal images • 3-5 min liver can be visualized clearly• 5-10min left and right hepatic ducts can be displaye
d• 15-30min gallbladder ,choledochus and duodenum
were seen clearly with the gradual decrease of radioactivity in the liver
• The time of radio-tracer appears in gallbladder and duodenum ≤ 60min
• if over 24 h,no bowel excretion is visualized ,high possibility of biliary atresia may exit
Clinical application
鉴别胆道闭锁( biliary atresia )和新生儿肝肝炎综合症( neonatal hepatitis syndrome )
诊断急性胆囊炎( Acute cholecystitis )判断胆道梗阻情况判断损伤或术后胆漏情况
Biliary atresia(胆道闭锁)图像特点:肝影消退缓慢,动态采集和延迟至 24 h,肠道内始终无放射性聚集。
Case 1, 患儿因临床黄疸查因,请对根据其 hepatobiliary scintigraphy 图像做其出最可能的诊断。
neonatal hepatitis
(新
生儿肝炎)
Case 2, 患儿因临床黄疸查因,请对根据其 hepatobiliary scintigraphy 图像做其出最可能的诊断。
case 3, A patient complaining of acute right quadrant pain. What is the most possible diagnose of the patient?
Acute cholecystitis
Questions
• 1. In hepatobiliary scintigraphy, the radio tracer can be up taken by ( ).
• A.hepatic cells B. vascular endothelial cells• C.Kupffer cells D. stellate cells E.biliary duc
t endothelial cells.• 2. 如何通过肝胆动态显像鉴别婴儿先天胆道闭锁和新生儿肝炎综合症?