PHYSIOPATHOLOGICAL SIGNIFICANCE OF TL-201 PER RECTUM SCINTIGRAPHY IN LIVER-CIRRHOSIS

To define the physiopathological significance Tl-201 per rectum scinti graphy, we compared results obtained using this method with direct mea surement of inferior mesenteric shunting, portal pressure, liver cellu lar function as evaluated by the Aminopyrine Breath Test and the size of esophagogastric varices and spleen, constituting, respectively, ind irect representation of azygos and splenic shunts. Results indicated t hat a high correlation exists between the measures of portal systemic shunt estimated by the per rectal method and those obtained by direct administration of the tracer in the inferior mesenteric artery. No cor relation was observed between Tl-201 per rectal results and portal pre ssure or with azygos and splenic shunting. Fair correlation was observ ed with the Aminopyrine Breath Test. This could be explained by the fa ct that both methods are altered in advanced liver disease. These resu lts suggest that the Tl-201 per rectal scintigraphy explores the porta l systemic shunt, which depends almost exclusively on the inferior mes enteric territory. While the limited territory explored by the method constitutes, undoubtedly, a limiting factor in detection and quantitat ion of total portal-systemic shunt, the specific information provided by the test could be useful in defining clinical and biological profil es of cirrhotic patients with inferior mesenteric shunting.