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目的 探讨99mTcECT动态扫描和断层扫描预测肝癌手术切除安全性的价值。方法 采用99mTc 植酸钠胶体肝再摄取和首次通过斜率原理 ,运用自编程序 ,检测 2 0例肝癌和 10例正常健康人的HBF、HAF、PVF。 16例肝癌再行断层扫描。划出手术预切除区 ,计算出功能肝切除率。结果 肝癌病人和正常人的HBF分别为 :142 4 9± 431ml/min ,15 0 7 5± 36 4 3ml/min ,(P >0 0 5 ) ;HAF为 :6 4 2 %± 2 3 6 %,35 7%± 6 2 %,(P <0 0 5 ) ;PVF为 :33 8%± 14 5 %,6 4 3%± 8 7%(P <0 0 5 ) )。 16例功能肝切除率 :10 %～ 2 0 %6例 ,2 1%～ 30 %7例 ,31%～ 40 %1例 ,41%～ 5 0 %1例 ,5 0 %以上者 1例 ,术后因肝功能衰竭死亡 1例。结论 99mTc 植酸钠动态及断层扫描能确定肝血流量和各种不规则肝切除术的功能肝切除率 ,预测切除术的风险。
Objective To investigate the value of 99mTcECT dynamic scanning and tomography in predicting the safety of surgical resection of liver cancer. Methods 99mTc sodium phytate colloid liver reabsorption and the first time through the slope principle, using self-compiled program to detect 20 cases of liver cancer and 10 cases of normal healthy people HBF, HAF, PVF. 16 cases of liver cancer tomography. Draw out the preoperative resection area, calculate the function of liver resection rate. Results The HBF of patients with hepatocellular carcinoma and normal controls were 142 4 9 ± 431 ml / min and 15 0 7 5 ± 36 4 3 ml / min, respectively (P 0 05). The HAF was 62 42 ± 2 36% , 35 7% ± 6 2% (P <0 05); PVF 33 8% ± 14 5%, 64 3% ± 8 7% (P 0 05)). Among the 16 cases, hepatic resection rate was 10% ~ 20% in 6 cases, 21% ~ 30% in 7 cases, 31% ~ 40% in 1 case, 41% ~ 50% in 1 case, One patient died of liver failure after operation. Conclusions The dynamic 99mTc sodium phytate and tomographic scan can determine the hepatic blood flow and functional hepatectomy for various hepatic resections and predict the risk of resection.