FULMINANT HEPATIC-FAILURE MONITORED BY TECHNETIUM-99M-DTPA-GALACTOSYL-HUMAN SERUM-ALBUMIN SCINTIGRAPHY

We describe a 43-yr-old woman with fulminant hepatic failure whose pro gress was monitored scintigraphically using Tc-99m-galactosyl-human se rum albumin (Tc-99m-GSA). On admission, the liver was atrophic and the heart was delineated distinctly by scintigraphy with Tc-99m-GSA. The receptor index, calculated by dividing the radioactivity of the liver region of interest by the radioactivity of the liver plus heart region s of interest at 15 min post-tracer injection, was very low, As the pa tient's condition improved, the right robe of the liver enlarged while the left lobe became atrophic; after 4 mo, the left lobe almost compl etely disappeared, Delineation of the heart gradually became less dist inct, and the receptor index slowly increased, Hepatic receptor imagin g with Tc-99m-GSA can define both the hepatic functional reserve and m orphological changes of the liver, so it is useful for the diagnosis a nd follow-up study of fulminant hepatic failure.