Effect of Propranolol on Portal Vein Pressure in Patients with Chronic Liver Disease: Evaluation by Perrectal Portal Scintigraphy.
- Author:
Young Ho RHO
;
Shin HAN
;
Hak Su KIM
;
Su Jin YOON
;
Yun Kweun KIM
;
So Yon KIM
;
Young Jung KIM
;
Min Koo CHO
;
Byung Yik PARK
;
Gwon Jun LEE
- Publication Type:Original Article
- Keywords:
Propranolol;
Tc-99m per-rectal portal scintigraphy;
Liver cirrhosis;
Portal pressure
- MeSH:
Classification;
Early Diagnosis;
Esophageal and Gastric Varices;
Fibrosis;
Heart;
Hemodynamics;
Hepatitis, Chronic;
Humans;
Liver Cirrhosis;
Liver Diseases*;
Liver*;
Portal Pressure;
Portal Vein*;
Propranolol*;
Radioactivity;
Radionuclide Imaging*;
Sodium Pertechnetate Tc 99m;
Varicose Veins
- From:Korean Journal of Nuclear Medicine
1999;33(4):388-397
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Propranolol is known to decrease portal pressure by reducing blood flow of portal vein. Per-rectal portal scintigraphy with Tc-99m pertechnetate has been introduced to evaluate the portal circulation and early diagnosis of liver cirrhosis. We evaluated the effects of propranolol on portal circulation by using per-rectal portal scintigraphy. MATERIALS AND METHODS: We analyzed the portal hemodynamics by per-rectal portal scintigraphy in 51 patients with liver cirrhosis, 10 chronic hepatitis and 10 normal subjects. 38 patients with cirrhosis underwent per-rectal portal scintigraphy before and after propranolol medication. Per-rectal portal scintigraphy was performed after per-rectal administration of 370 MBq of Tc-99m pertechnetate. The shunt index was calculated as the ratio, expressed as a percentage of heart radioactivity to the sum of heart and liver radioactivity during the first 30 seconds. RESULTS: The shunt index in 40 patients with cirrhosis (59.8+/-27.2%) was significantly higher than that of normal control (5.0+/-1.2%, p<0.01) and chronic hepatitis (11.4+/-3.5%, p<0.01). Shunt index was significantly different according to Child's classification and the degree of esophageal varix (p<0.01). After propranolol medication, shunt index was significantly decreased from 59.9+/-27.3% to 51.3+/-15.3% (p<0.01) in 38 patients with liver cirrhosis. There was no significant difference of the amount of shunt index reduction after propranolol according to Childs' classification and the degree of esophgageal varix. CONCLUSION: The effect of propranolol on portal circulation was demonstrated as decreasing shunt index on per-rectal portal scintigraphy in patients with liver cirrhosis. Per-rectal portal scintigraphy may be useful to evaluate the portal circulation and to predict the effect of propranolol in patients with liver cirrhosis.
