대한핵의학회지 (1967년~2009년)
대한핵의학회지 1970;4(1)37~6
간경변증에 있어서의 주요 간주사 소견과 식도정맥류와의 상관성에 관하여 ( Correlation of Major Scan Findings and Esophageal Varices in Liver Cirrhosis )
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Author 안재성(Jae Sung Ahn),박용휘(Yong Whee Bahk),임정익(Jung Ik Yim),
Affiliation
Abstract

In an endeavor to help understand some typical scan findings and portal hemodynamics in liver cirrhosis, several commonly occuring scan changes and esophageal varices as demonstrated by esophagram were correlated one another from quantitative and qualitative stand points. Clinical materials consisted of 34 patients with proven diagnosis of liver cirrhosis and esophageal varcies. Liver scan was performed with colloidal 198-Au and the changes in the size and internal architecture of the Liver, splenic uptake and splenomegaly were graded and scored by repeated double-blind readings. The variceal changes on esophagrams were also graded according to the classification of Shanks and Kerley following modification. Of 34 patients, 91% showed definite reducting in liver voulume(shrinkage) constituting the most frequent scan change. The splenic uptake and splenomegaly were noted in 73.5 and 79.4%, respectively. The present study revealed no positive correlation between the graded scan findings including shrinkage of the liver, splenic uptake or splenomegaly and severity of variceal changes of the esophagus. Exceptionally, however, apparently paradoxical correlation was noted between the severity of mottling and varces. Thus, in the majority(73.5%) of patients mottling were either absent or mild. This interesting observation is in favor of the view held by Christie et al. who consider the mottlings to be not faithful expression of actual scarring of the cirrhosis liver. This also would indicate that variceal changes are to be the results of intrahepatic arteriovenous shunting of blood with hypervolemic load to the portal system rather than simple hypertension secondary to fibrosis and shrinkage.

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