A study of colloidal scintigraphy in alcoholic liver diseases: Discordancefrom asialo-scintigraphic findings

Background: Our study was undertaken to check the discordance between findi ngs from Tc-99m-Sn colloidal reticuloendothelial scintigraphy (RESS) and Tc -99m-GSA asialo-scintigraphy (GSA, a technique for evaluation of liver pare nchymal cell density and function) and to analyze the discordance in relati on to functional disturbances. We compared data between patients with alcoh olic liver diseases (ALD) and patients with viral liver diseases (VLD). Methods: The subjects of this study were 40 patients with chronic liver dis ease (17 with ALD and 23 with VLD). We used the liver uptake ratio of the t racer of the Sn colloid (SnL15, %), the liver uptake rate (GSAL(15), %), an d the Rmax (an indicator of total liver receptors) as indices of liver scan s. Results: GSAL(15) was sometimes nondiscordant from SnL15. The patients were divided into two groups: the nondiscordant group (26 cases where the balan ce/sum of the two variables was <25%) and the discordant group (14 cases wh ere the balance/sum was greater than or equal to 25%). SnL15 was 41.6 +/- 1 6.2% in the nondiscordant group and 42.7 +/- 16.3% in the discordant group (p = 0.80). GSAL(15) was 34.3 +/- 12.1% in the nondiscordant group and 21.5 +/- 8.1% in the discordant group (p = 0.001). Rmax was 0.33 +/- 0.17 in th e nondiscordant group and 0.113 +/- 0.008 in the discordant group (p = 0.00 2). Thus, the SnL15, as determined by RESS, did not differ significantly be tween the nondiscordant and discordant groups, whereas GSAL(15) was signifi cantly unfavorable in the discordant group as compared with the nondiscorda nt group. SnL15 as determined by RESS did not differ significantly between the ALD group (40.4 +/- 18.7%) and the VLD group (43.5 +/- 15.0%) (p = 0.59 ), whereas Rmax as determined by GSA was significantly improved in the ALD group (0.34 +/- 0.20) compared with the VLD group (0.20 +/- 0.4) (p = 0.02) . Conclusions: Liver cell function was lower in cases that showed discordance between liver cell function and reticuloendothelial function compared with cases without such discordance, although reticuloendothelial function did not differ between discordant and nondiscordant groups. Liver cell function was better in cases of ALD than in cases of VLD, whereas reticuloendotheli al function did not differ between the ALD group and the VLD group.