Liver scintigraphy indications and contraindications

Scintigraphy is a modern-day diagnostic technique that permits you to get details about offenses of the functions of the liver and its system as a whole. It is based upon the intro of a radioactive pharmaceutical preparation (RFP) identified with particular isotopes into the interior, giving off radiation in the quantity of 2 MBq/kg.

For example, technetium (99mTc). This diagnostic technique is recommended for tracking after long-lasting treatment or surgical treatment. The treatment permits you to examine the size and shape of the organ, in addition to its structure.

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What is liver scintigraphy

Radioisotope scanning of the liver is utilized as a technique for finding inflammatory procedures, cirrhotic defect, neoplastic developments and benign additions. The function of the diagnostic treatment is not just to figure out the discrepancies in the practical activity of cells, however likewise to measure offenses in the structure of the organ tissue.

Since scintigraphic assessment comes from the group of radiation techniques, in order to keep a balance in between diagnostic effectiveness and hazardous results, the volume of the injected drug is evaluated separately. Before scanning, an unique preparation is injected within, which includes 2 parts:

  • a vector blood particle that permits the drug to be provided to the liver tissue,
  • isotopic radiomarker developed to send radiation to the recording part of the gamma video camera.

Half an hour after the administration of the drug, the client is put in a specialized device, the so-called gamma video camera, in which more improvement of the radiated RFP radiation happens. As an outcome, a map is gotten on which locations with boosted or pathological build-up of formerly administered RFP are marked.

According to modern-day information, for the most effective and total acquiring of details about the organ, it is advised to utilize 3 techniques of radiation diagnostics in parallel, for that reason, ultrasound assessment, calculated tomography, magnetic resonance imaging and angiographic research studies are carried out together with scintigraphy.

Hepatoscintigraphy is carried out in 3 equally perpendicular forecasts – frontal, dorsal and ideal lateral.

There are 2 kinds of radioisotope research studies of the liver:

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  • Static. This technique identifies the physiological functions of the organ, the capability of the tissue to eliminate RFP. A colloidal service with 99mTc is utilized for her, which does not hurt other organs. Scanning is performed 30-60 minutes after the injection of the service. It likewise takes a minimum of half an hour to produce images. Then they are processed for another 20 minutes.
  • Dynamic. Diagnostics of this type assesses the biliary system. For example, stagnant procedures in the gallbladder, permits to distinguish parenchymal and obstructive jaundice, by figuring out the level of bile duct stenosis. Iminodiacetic acid 99mTc (HIDA) is utilized for vibrant examination of the outcomes. Sometimes vibrant scintigraphy requires to be duplicated. In this case, it is recommended 1 hour after the very first.
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Both types of examinations are performed on an outpatient basis. The procedure does not cause pain or discomfort.

Indications for

This procedure is recommended to confirm or deny diagnoses of the liver and its system:

  • with chronic hepatitis with a risk of developing cirrhosis,
  • cirrhosis of the liver,
  • the formation of primary or secondary metastases and tumors,
  • an enlarged spleen or liver
  • damage by hepatomegaly or splenomegaly,
  • cyst or abscess damage
  • suspicion of echinococcosis,
  • fatty liver hepatosis,
  • the presence of lymphogranulomatosis.

This type of examination is mandatory if there is a suspicion of the growth of metastases from the abdominal cavity to the liver, as well as to monitor the condition of the gland after a recent operation.

Противопоказания

The advantages of scintigraphy, such as painlessness and non-invasiveness, create a minimal risk for the development of allergic reactions and other complications. Therefore, this examination method can be applied to almost all patients. The exception is:

  • pregnancy,
  • lactation period,
  • individual intolerance to the radio indicator
  • patients in serious condition.

The dynamic view of the study is prohibited with recent endoscopic or radiopaque diagnostics. In this case, a break of at least two weeks is required between these procedures. Without special indications, it is not carried out to children.

On rare occasions, the treatment may trigger a short-term spike in blood pressure and frequent urge to urinate.

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Preparation and implementation

No special preparation is required before the treatment. The main and obligatory requirement is to go to the toilet before the procedure. Since the diagnostics can take a long time, during which it is impossible to move. When diagnosing a dynamic view, the patient needs to take two raw chicken eggs with him to produce normal conditions for the outflow of bile after eating them on an empty stomach.

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You also need to bring with you the results of previous studies (X-ray, CT, ultrasound, etc.), an outpatient card and a doctor’s opinion. This is required so that a specialist can establish the dose of a radioactive preparation that is acceptable for administration.

Pregnant and lactating women, before the procedure, need to warn a specialist about this. In addition, mothers are advised to stop breastfeeding for two days after the scintigraphy. Since radioactive substances can enter the baby’s body along with breast milk.

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Already in the office, the patient is injected intravenously with a so-called radioactive indication and waiting for some time for the accumulation of radioactive isotopes in the gland. Depending on the human body, this takes 20 to 30 minutes. After the isotopes have accumulated, the patient is placed on a unique table and scanned with a gamma camera. As a rule, several pictures are taken, which take from 30 to 60 minutes.

After the treatment, the person does not require any rehabilitation, since the scintigraphy is not invasive and completely painless.

Explanation of outcomes

The scan results are processed by a radiologist using a computer in numerous phases:

  • Visual evaluation and recognition of suspicious locations.
  • Plotting a chart according to the “time-activity” type, which permits you to figure out the rate of proliferation of a radioactive compound in an organ.
  • Mathematical processing of the chart.

As an outcome, professionals get a total photo of the liver and its tissues (gallbladder with bile ducts, spleen, etc.).

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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