BILIARY SCINTIGRAPHY - APPLICATION TO THE STUDY OF CHRONIC CHOLESTASIS

In a sample population of 49 subjects (7 normal, 42 with various liver diseases), the parameters of the activity/time curve of trimethylbrom o-iminodiacetic acid (TBIDA) biliary scintigraphy were compared with t he clearances of bromosulfophthalein (BSP) and indocyanin green (ICG). Correlation between Tl/2 and P2 BSP slope was r = 0.50 (n = 33 ; P < 0.01). Correlation between Tmax TBIDA and fractional ICG clearance (P ICG) was r = 0.65 (n = 44 ; P < 0.001). In 23 cases of chronic cholest asis correlations remained significant (Tl/2-P2 BSP: r = 0.53 n = 17 ; P = 0.02 ; Tmax-P ICG : r = 0.59; n = 17 P < 0.01). A prospective stu dy of 11 cases of chronic intrahepatic cholestasis (primary biliary ci rrhosis 8, primary sclerosing cirrhosis 3) showed that these two types of tests varied concordantly. Biliary scintigraphy, therefore, seems to be an accurate method to explore hepatocellular mass (degree of hep atic insufficiency) and cholestasis. The validation of biliary TBIDA s cintigraphy as hepatobiliary functional exploration method and the pos sibility to study intrahepatic <<regions of interest>> defined a prior i would make it possible to obtain a functional estimate of hepatic se gments or lobes, for example before wide liver excision.