A child with Alagille syndrome,
characterized by intrahepatic bile duct paucity, developed severe liver
cirrhosis and was referred for liver transplantation. In the pre-transplantation
evaluation, scintigraphic scans were performed using 99mTc-galactosyl serum
albumin (99mTc-GSA) as a hepatoreceptor binding agent and 99mTc-pyridoxyl-5-methyl-tryptophan
(99mTc-PMT) as a hepatobiliary agent. These studies demonstrated severe
hepatobiliary dysfunction with an area of increased focal uptake in the
liver. Histological examination at surgery confirmed that this focal lesion
was an area of compensatory hyperplasia in advanced biliary cirrhosis.
We present the usefulness of these tracers for detecting the focal hyperplasia
of the liver.
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