【摘要】 目的 探讨核素肝脾显像在评估部分性脾栓塞术(PSE)疗效中的价值。方法 对20例肝硬化脾功能亢进病人PSE治疗前后进行放射性核素肝脾显像。应用感兴趣区技术测定肝、脾区活性,计算脾栓塞分数(FSE),并对FSE与疗效及并发症间的关系进行相关分析。结果 随着FSE的增高,术后发热时间延长;术后白细胞和血小板等明显恢复,且与FSE有明显的相关关系,r分别为0.638(P<0.05)和0.856(P<0.01)。5例术后出现并发症的病人FSE均在70%以上。结论 核素肝脾显像定量测定FSE简便易行,可为临床医师准确掌握部分性脾栓塞体积和评估疗效等提供较可靠的客观依据;FSE控制在40%～70%时PSE治疗可取得较满意的疗效。

Li Yaming, Han Mingjun, ChuiJun, et al. The First Clinical College, China Medical University, Shenyang, 110001

【Abstract】 Purpose To investigate the value of liver-spleen radionuclide scintigraphyin therapeutic of partial spleen embolization (PSE). Methods Liver-spleen radionuclide scintigraphy was performed in 20patients with cirrhosis and hypersplenism before and after therapeutic partial spleenembolization. The fraction of spleen embolization (FSE) and spleen activity index (SAI)were calculated using region of interest (ROI) technique. The correlation analyses weremade between FSE and efficacy of PSE and its complications. Results The results showed that the larger the FSE was, the longerthe postoperative fever lasted. The recovery of white blood cell and platelet counts weresignificant after PSE and highly correlated with FSE (r=0.638, P<0.05, and r=0.856,P<0.01). Complications occured in 5 patients with FSE above 70%. Conclusions Quantitative measurement of FSE by liver-spleenradionuclide/scintigraphy is simple and easy, provides objective and reliable data of theembolized spleen fraction and the therapeutic effectiveness for clinicians. The resultsindicate that better therapeutic results come along with FSEs ranged from 40% to 70%.

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