폐쇄성(閉鎖性) 황달의 진단에 관한 핵의학적(核醫學的) 고찰

Scan Manifestation and Trace-Dose Radiogold Clearance Rates in Obstructive Jaundice

The present study has been undertaken to analyze scan manifestations in obstructive jaundice. Scan changes were cprrelated with the duration of jaundice. In addition, clearance rates of trace dose of colloidal radiogold were assessed in each case. The materials were consisted of 19 cases with surgically and/or histopathlogically verified obstructive jaundice from various causes including common duct stone, empyema of the gall bladder and carcinoma of the pancreas head etc. Blood clearance rates of colloidal $^{198}Au$ were determined after the injection of 8 uCi by simple geometrical drawing of recorded strip charts. Scan was performed following additional injection of the same radiogold. In 16 out of 19 cases, the scan revealed rather typical "arborifrom" mottlings around the porta hepatis. The intensity and appearance of such mottlings on the scan was related with the duration of jaundice and level of serum bilirubin and alkaline phosphatase. The blood clearance rates remained to be within normal range in 74 percent of the patients. In the remaining 26 percent, clearance rates ranged between 4.1 and 6 minutes. It is concluded that the association of "arboriform" mottlings and normal or mildly delayed clearance rates in the patients with jaundice is characteristic of obstructive changes in the biliary system.