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RISS 인기검색어
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- 저자 : 조석신(Seok Shin Cho) (검색결과 2 건)
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만성 간질환에서의 ICG - Rmax 와 Thallium - 201 Test per Rectum ( Sunt Index ) 의 임상적 의의
이경상(Kyung Sang Lee),황선호(Seon Ho Hwang),함준수(Joon Soo Hahm),이종철(Jong Chul Rhee),기춘석(Choon Suhk Kee),박경남(Kyung Nam Park),이민호(Min Ho Lee),정화순(Wha Soon Chung),조석신(Seok Shin Cho),이재원(Jae Won Lee) 대한내과학회 1994 대한내과학회지 Vol.46 No.1
N/A Objectives: Thallium-201 test per rectum (shunt index) and ICG-Rmax have been used for studying the portosystemic shunt and the functional reserve of liver. The clinical values of shunt index and ICG-Rmax in pateints with chronic liver disease were evaluated using the data obtained in 74patients. Methods: 0.5mCi thallium-201 was administered per rectum to 37 patients witchronic active hepatitis (CAH) and 37Patients with liver cirrhosis, and the heart to liver uptake ratio was taken at 20min. ICG-Rmax was also taken using Paumgartner`s method. We used simple linear regression and ANOVA methods for the correlation between ICG Rmax and shunt index. Results: 1) The mean shunt index was 0.251±0. 140 in CAH group and 0.565±0.351 in cirrhosis group (P<0,005). 2) The mean ICG-Rmax was 1.720±l.320 (mg/kg/ min) in CAH group and 0.867±0.625 in cirrhosis group (P<0 005). 3) There was no significant correlation between ICG- Rmax and shunt index in CAH group (P=0.358). 4) Correlation between ICG-Rmax and shunt index was significant in cirrhosis group (P=0,001; R-square= 0 321; 1/ICG-Rmax=2 64 * shunt index+0.49) Conclusions: Thallium-201 scintigraphy per rectum and ICG-Rmax may be useful in diagnosis of chronic liver diseases, especially differentiating CAH from cirrhosis. These study will help us to predict the prognosis of chronic liver diseases and give us more information for the treatment of chronic liver diseases.
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만성 간 질환에서 경직장 Thallium-201 간 스캔의 임상적 의의 및 방사능 분포 양상
박경남,이민호,박근태,김진배,최호순,기춘석,함준수,윤병철,조석신,박문승 대한소화기학회 1998 대한소화기학회지 Vol.30 No.4
Background/Aims: Quantification of the portosystemic shunt is important for properly managing the patients, predicting prognosis and adjusting dosages of oral iirugs for chronic liver disease. In this study, we evaluate the clinical significance of thallium-201 liver scan for chronic liver diseases mainly in the aspects of radioactivity distribution. MethndIs: From February 1991 to April 1994, 54 patients with chronic liver disease(25 patients with chi anic active hepatitis, 22 Child A cirrhotics, and seven Child B cirrhotics) underwent the scan. The shunt index(H/L ratio) was determined and was classified into three groups according to the patterns of distributioo of radioactivity performed in them(Type I: normal, Type II: filling defect in the liver with or without extra hepatic radioactivity, Type III: extrahepatic radioactivity only) Results: The shunt index in cirrhotics was higher than chronic active hepatitis(0.56±0.38 vs 0.35±024 p$lt;0.05). In terms of patterns of distribution of radioactivity l3 patients among 14 patients with type I(93%) were patients with chronic active hepatitis, 14 patients among 25 patients with type II(56%) were cirrhotics and the remaining were patients with chronic active hepatitis. 14 patients among 15 patients with type Ill were cirrhotics. In terms of shunt indices according to the patterns of distribution of radioactivity the shunt index of type III was higher than that of type II and that of type II was higher than type I(0.79±0,40:0.39±0.29 p$lt;0.01, 0.39±0.29:0.21±0.14 p$lt;0.05). Conclusions: Determination of the shunt index using a per rectal thalliurn-201 liver scan wa:$gt; a useful method for quantifying the porto- systemic shunt noninvasively and it can differentiate chroruc active hepatitis from cirrhosis. Considering that the graver the chronic liver disease is, that moie frequent type III is, we assume that transformation from type I to type III indicates a progres. Ion of chronic active hepatitis to cirrhosis.
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