Radionuclide angiography was used to generate first-pass radioactivity vs. time curves for the left heart, right hepatic lobe, right lung, spleen, and both kidneys following rapid intravenous injection of 20 mCi (740 MBq) of 99mTc-pertechnetate. Seven normal subjects were examined as well as 57 cirrhotic patients, who also underwent angiographic grading of portal venous perfusion. For analysis, two time points were identified: (a) t0, when 99mTc first entered the liver (the initial rise of either curve); and (b)tc, when 99mTc was maximal in abdominal organs (the renal peak). Analysis was based on the slopes of the two phases of the hepatic curves t0 + 7 seconds and Tc + 7 seconds; this time selection permitted analysis of all curves. The hepatic perfusion index (HPI) = slope (tc + 7 secs)/slope (t0 + 7 secs) + slope (tc + 7 secs). The mean HPI for the normal subjects was 66% +/- 7; for the cirrhotic patients with angiographic Grades I, II, III, and IV, the HPI was 52% +/- 9, 37% +/- 6, 15% +/- 7, and 3% +/- 4, respectively. Correlation between HPI and angiography was significant (p less than 0.001). This method offers a readily available, rapid, relatively inexpensive, and quantitative method of grading the ratio of portal venous to total hepatic blood flow.
The measurement of portal venous flow to the liver is important in the evaluation of patients for shunt surgery. A previous report described a method using slope analysis of hepatic radionuclide angiograms to generate an index of relative portal flow, which correlated well with angiographic grades of portal perfusion. The present report describes a refinement in bolus administration and a modification in technique that appear to reflect true portal venous flow more accurately. A total of 109 studies was performed, including seven normal and 80 cirrhotic patients. The method was reproducible (r = 0.998) and showed good correlation with the angiographic grades of perfusion (r = -0.906).
Cadmium, zinc, copper levels and zinc‐copper, zinc‐bromine, iron‐zinc, iron‐copper and iron‐bromine ratios are measured in neoplastic and normal kidney samples from humans by the particle induced x‐ray emission analysis (PIXE) technique. It is found that cadmium which is normally present in the tubular cells of kidney is not detectable in tumor samples. It is also observed that the zinc‐copper ratios in all neoplastic kidney tissues are decreased, but this observation cannot be extended to other element ratios.
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