Comparison of Liver Blood Flow Values Estimated by the Bromsulphalein and by the Radiogold Method

Abstract

In a previous paper (1) we have described a method of following the disappearance of intravenously injected colloidal radioactive gold from the circulation in man and have discussed the possibilities of calculating liver blood flow from the disappearance rate constant as the fraction of blood volume perfusing the liver per unit time.If liver blood flow values estimated in this way could be demonstrated to be correct this method should have many advantages over other methods currently in use: it does not require hepatic vein catheterization; with only one blood sample withdrawn for determination of hematocrit and plasma volume, it does not involve any undue blood loss to the patient; being exceedingly simple and mechanized to a considerable extent by the use of counting rate meters and recorders, it can be carried out by a single technician; it can be repeated several times without exposing the patient to any risk thereby enabling observation of changes in hepatic circulation over any period of time.Hepatic blood flow values estimated by this method in 25 normal subjects (18 males and 7 females) were found to average 1310 ml. per min.(1) and thus to be somewhat lower but still within the range of normal values reported by other groups who used the bromsulphalein or other methods. However, even this difference might not have been a real one. In this laboratory the observed venous hematocrit is corrected for trapped plasma and for the uneven distribution of cells and plasma within the whole body circulation. with the average normal radiogold results, appear to have used any correction of the hematocrit. It might, therefore, well be that the difference between average hepatic blood flows estimated by these two methods in different groups of normal subjects has been caused by the difference in the methods of calculating blood volume.However, a few experiments designed to investigate the efficiency of the liver phagocytes to remove the colloid particles from the blood passing through the liver, indicated that the radiogold method underestimates the true hepatic blood flow by almost 20 per cent (1). If this is true a direct comparison of BSP and radiogold results should reveal a real difference in the calculated flow values. Simultaneous estimations of hepatic blood flow by these two methods were, therefore, performed in 15 subjects the results of which are presented in this paper. METHODSMaterial. The subj ects studied were hospitalized patients in whom for diagnostic purposes a heart or hepatic vein catheterization was warranted. Therefore, none of the subjects could be considered to be "normal."Catheterization.

Estimation of the hepatic blood flow in the dog with the Xe133 and hydrogen wash-out, Au198-colloid uptake techniques and with the electromagnetic flowmeter

“…They have attained some favor in consequence of their simplicity and because no expensive and complicated equipment is required. The colloidal radiogold clearance seems to be also a very promising technique ~IO, 18,22).…”

The Estimation of Hepatic Blood Flow and Intrahepatic Shunted Blood Flow by Colloidal Heat-Denatured Human Serum Albumin Labeled With I131

“…If E is not known, then the measurement of hepatic blood flow is called "minimal hepatic blood flow" (MHBF), since it is less than the total hepatic blood flow (THBF), and may be calculated from the equation MHBF (ml/min) = K min-' X blood volume [3] Minimal hepatic blood flow = 4,100 X 0.346 = 1,420 ml per minute. PTA (0) = peripheral plasma total activity of I"'.…”