The utility of the macro-aggregated albumin lung perfusion scan in the diagnosis and prognosis of hepatopulmonary syndrome in cirrhotic patients candidates for liver transplantation
| Autor: | Israel Grilo, Francisco-Jesús López-Pardo, M.T. Ferrer, Antonio Grilo Reina, J.M. Sousa, Francisco Ortega-Ruiz, Juan Manuel Pascasio, Juan Luis Tirado, Miguel Ángel Gómez-Bravo, María J. Rodríguez-Puras |
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| Rok vydání: | 2017 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_treatment 030230 surgery Liver transplantation Severity of Illness Index Gastroenterology Hypoxemia 0302 clinical medicine Prospective Studies 030212 general & internal medicine Respiratory system Hypoxia Prospective cohort study Hepatopulmonary syndrome Lung Ascites Organotechnetium Compounds General Medicine Middle Aged respiratory system Prognosis Survival Rate Cirrhosis Echocardiography Pulmonary vascular diseases Female medicine.symptom Adult medicine.medical_specialty Sensitivity and Specificity Preoperative care 03 medical and health sciences Albumins Internal medicine Preoperative Care Contrast echocardiography otorhinolaryngologic diseases medicine Humans lcsh:RC799-869 Radionuclide Imaging Survival rate business.industry medicine.disease Liver Transplantation Surgery Concomitant lcsh:Diseases of the digestive system. Gastroenterology Radiopharmaceuticals business Follow-Up Studies Hepatopulmonary Syndrome Perioperative care |
| Zdroj: | Revista Española de Enfermedades Digestivas, Volume: 109, Issue: 5, Pages: 335-343, Published: MAY 2017 Revista Española de Enfermedades Digestivas v.109 n.5 2017 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname Revista Espanola de Enfermedades Digestivas, Vol 109, Iss 5, Pp 335-343 |
| ISSN: | 1130-0108 |
| DOI: | 10.17235/reed.2017.4219/2016 |
| Popis: | Background: The macro-aggregated albumin lung perfusion scan (99mTc-MAA) is a diagnostic method for hepatopulmonary syndrome (HPS). Aim: To determine the sensitivity of 99mTc-MAA in diagnosing HPS, to establish the utility of 99mTc-MAA in determining the influence of HPS on hypoxemia in patients with concomitant pulmonary disease and to determine the correlation between 99mTc-MAA values and other respiratory parameters. Methods: Data from 115 cirrhotic patients who were eligible for liver transplantation (LT) were prospectively analyzed. A transthoracic contrast echocardiography and 99mTc-MAA were performed in 85 patients, and 74 patients were diagnosed with HPS. Results: The overall sensitivity of 99mTc-MAA for the diagnosis of HPS was 18.9% (14/74) in all of the HPS cases and 66.7% (4/6) in the severe to very severe cases. In HPS patients who did not have lung disease, the degree of brain uptake of 99mTc-MAA was correlated with the alveolar-arterial oxygen gradient (A-a PO2) (r = 0.32, p < 0.05) and estimated oxygen shunt (r = 0.41, p < 0.05) and inversely correlated with partial pressure of arterial oxygen (PaO2) while breathing 100% O2 (r = -0.43, p < 0.05). The 99mTc-MAA was positive in 20.6% (7/36) of the patients with HPS and lung disease. The brain uptake of 99mTc-MAA was not associated with mortality and normalized in all cases six months after LT. Conclusions: The 99mTc-MAA is a low sensitivity test for the diagnosis of HPS that can be useful in patients who have concomitant lung disease and in severe to very severe cases of HPS. It was not related to mortality, and brain uptake normalized after LT. |
| Databáze: | OpenAIRE |
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