消 化 系 统 山西医科大学第一医院核医学科
内容 肝脾胶体显像 肝血流灌注、血池显像 胃肠道出血显像 异位胃粘膜显像 肝胆动态显像 胃肠功能测定 胃幽门螺杆菌检测 唾液腺显像
肝脾胶体显像
85%肝脏 原理 静脉 5%骨髓 10% 脾脏 放射性 胶体
显像剂 99Tcm-SC（硫化锝胶体） 颗粒大小为0.1～0.5 μm 99Tcm-植酸盐 水溶性无色透明物 水溶性无色透明物 静脉注入后与血液中的Ca2+鳌合 形成99mTc-植酸钙胶体(大小0.3 μm)
显像方法 显像剂 99Tcm-SC 剂量 4~6mCi 显像时间 20m 体位 ANT、POST、RLA、LLA，LAO、RPO 控制呼吸幅度，减少肝脾活动伪影
三角形，右叶放射性分布较高，右叶下缘左叶放射性较低 ANT 正常图像 RLA 三角形，右叶放射性分布较高，右叶下缘左叶放射性较低 POST 逗点状、卵圆形或菱形，中部放射性分布较高，周边较低 左叶外端和右叶间有一个放射性减低带 Tc-植酸钠肝胶体显像
横断面 冠状面 肝胶体断层显像 矢状面
异常图像 位置异常 大小异常 形态异常 放射性分布异常
临床应用 不能施行MRI、CT 阴性对照、定位 肝脏肿块，肝腺瘤、 FNH 诊断布—卡氏综合征 肝血池诊断肝血管瘤 111In白细胞诊断感染 131I-MIBG嗜铬细胞瘤 99Tcm-MAA肝动脉灌注 67Ga肝癌 单克隆抗体作肿瘤定位 153Xe局灶性脂肪变性
Case 1 Tc-植酸钠 肝右叶占位性病变
Tc-植酸钠、右叶肝癌 Case 2
Tc-植酸钠 肝右叶多发血管瘤 Case 3
Tc-植酸钠、多囊肝 Case 4
Case 5 Focal Nodular Hyperplasia
SPECT images of the liver were obtained and correlated with a recent outside CT study. There is focally increased uptake involving the majority of the medial segment of the left hepatic lobe. This region of increased uptake corresponds to the abnormality identified on the CT study.
Case 6 Focal Nodular Hyperplasia
Focal nodular hyperplasia is a benign tumor seen more commonly in women (80-90 % of documented cases) than men. The origin is unknown, but a vascular malformation is suspected. The lesion frequently contains a central scar, and is characterized by the presence of Kupffer cells.
Findings: Mildly increased colloid uptake is seen in a large lesion involving the left lobe of the liver. This corresponds to a well circumscribed 7 cm mass at this location on the CT. Note that these are non-attenuation-corrected images, so there should be apparently decreased activity in deeper structures. The lesion is more intense that the immediately adjacent liver.