Bingxiu RenDepartment of Nuclear Medicine,the first affiliated hospital of Kunming Medical

UniversityMar.31,2014

肝胆显像（ Hepatobiliary scintigraphy ）

Bingxiu Ren, PhD, attending doctor.

Mayjor in nuclear imaging & therapy.

Email:yn76ren@126.com

Phone: +86 13529168551

显像原理放射性示踪剂（ radiotracers ） 肝细胞摄取 分

泌至胆汁 排泄至肠道 .

Ideal agents exihibit high extraction efficiency by live

r,rapid transit, and high concentration in bile.

： radiotracer：胆汁

肝胆系统图

胆红素肠肝循环及肝胆动态显像原理示意图

Radiopharmaceuticals （放射性药物）• 99mTc-imniodiactic acid(IDA): 可与胆汁均匀混合，

早期常用，但图像质量易受血液中总胆红素浓度的影响 .

• 99mTc-MIBI can be up taken and secreted by hepato

cytes, often used without concerning the TBIL level.

Normal images • 3-5 min liver can be visualized clearly• 5-10min left and right hepatic ducts can be displaye

d• 15-30min gallbladder ,choledochus and duodenum

were seen clearly with the gradual decrease of radioactivity in the liver

• The time of radio-tracer appears in gallbladder and duodenum ≤ 60min

• if over 24 h,no bowel excretion is visualized ,high possibility of biliary atresia may exit

Clinical application

鉴别胆道闭锁（ biliary atresia ）和新生儿肝肝炎综合症（ neonatal hepatitis syndrome ）

诊断急性胆囊炎（ Acute cholecystitis ）判断胆道梗阻情况判断损伤或术后胆漏情况

Biliary atresia（胆道闭锁）图像特点：肝影消退缓慢，动态采集和延迟至 24 h,肠道内始终无放射性聚集。

Case 1, 患儿因临床黄疸查因，请对根据其 hepatobiliary scintigraphy 图像做其出最可能的诊断。

neonatal hepatitis

（新

生儿肝炎）

Case 2, 患儿因临床黄疸查因，请对根据其 hepatobiliary scintigraphy 图像做其出最可能的诊断。

case 3, A patient complaining of acute right quadrant pain. What is the most possible diagnose of the patient?

Acute cholecystitis

Questions

• 1. In hepatobiliary scintigraphy, the radio tracer can be up taken by ( ).

• A.hepatic cells B. vascular endothelial cells• C.Kupffer cells D. stellate cells E.biliary duc

t endothelial cells.• 2. 如何通过肝胆动态显像鉴别婴儿先天胆道闭锁和新生儿肝炎综合症？