Possible role of the scintigraphic estimation of the relative liver perfusion in the diagnosis and therapy of liver carcinomas.

BACKGROUND: The aim of the study is evaluation of the possible role of the scintigraphic estimation of the relative liver perfusion in diagnosis and the choice of treatment of liver carcinomas. MATERIAL AND METHODS: Hepatic perfusion index was obtained by dynamic scintigraphy in 126 patients. RESULTS: In the control group values did not differ from the value in the patients with benign tumors (p > 0.05). However, in hepatocellular carcinoma and liver metastases of different tumors, HPI values were significantly decreased in comparison to controls and benign tumors (p < 0.01), but they didn't differ between themselves (p > 0.05). The values were especially low in the patients with malignant diseases in the liver accosciated with vascular disturbances in the portal system. CONCLUSION: HRA could be easily done during the different conventional nuclear medicine methods. It can be an useful method for the assessment of different degrees of hemodynamic alterations in portal system, for differential diagnosis of benign and malignant liver tumors, as well as for assessment of the liver tissue and tumor perfusion, which might be helpful in the decision making for the undertaking of intraarterial (radionuclide, chemotherapy etc.) therapy.

Helicobacter pylori infection in various groups of patients studied, estimated by 14C-urea breath test.

The aim of this study was the detection of helicobacter pylori (HP) infection and estimation of the clinical validity and the accuracy of the 14C-urea breath test in the groups of patients studied. A total of 248 patients with gastric diseases were examined. There were 38 patients with gastric ulcer, 41 with duodenal ulcer, 43 with gastroduodenitis erosiva, 26 with hiatus hernia, 36 with gastric carcinoma and 64 patients with gastritis. There were 103 true positive (TP), 139 true negative (TN), 4 false negative (FN) and 2 false positive (FP) patients. There was no significant difference in the incidence of the HP infection between the groups of patients studied (p > 0.05). Sensitivity of the method was 96.3%, specificity 98.6%, positive predictive value 98.1%, negative predictive value 97.2% and accuracy 97.6%. Our results point out that the method is very accurate for the detection of HP infection.

Color Doppler sonography and angioscintigraphy in hepatic Hodgkin's lymphoma.

AIM: To estimate the characteristics of Color Doppler findings and the results of hepatic radionuclide angiography (HRA) in secondary Hodgkin's hepatic lymphoma. METHODS: The research included patients with a diagnosis of Hodgkin's lymphoma with metastatic focal lesions in the liver and controls. Morphologic characteristics of focal liver lesions and hemodynamic parameters were examined by pulsed and Color Doppler in the portal, hepatic and splenic veins were examined. Hepatic perfusion index (HPI) estimated by HRA was calculated. RESULTS: In the majority of patients, hepatomegaly was observed. Lesions were mostly hypoechoic and mixed, solitary or multiple. Some of the patients presented with dilated splenic veins and hepatofugal blood flow. A pulse wave was registered in the centre and at the margins of lymphoma. The average velocity of the pulse wave was higher at the margins (P > 0.05). A continuous venous wave was found only at the margins of lymphoma. There was no linear correlation between lymphoma size and velocity of pulse and continuous wave (r = 390, P < 0.01). HPI was significantly lower in patients with lymphomas than in controls (P < 0.05), pointing out increased arterial perfusion in comparison to portal perfusion. CONCLUSION: Color Doppler ultrasonography is a sensitive method for the detection of neovascularization in Hodgkin's hepatic lymphoma and estimation of its intensity. Hepatic radionuclide angiography can additionally help in the assessment of vascularisation of liver lesions.