Yasuo Niio

Abnormal pulmonary accumulation of indium-111 chloride in Pneumocystis carinii pneumonia as detected by bone marrow scintigraphy

PURPOSE Unusual pulmonary uptake of In-111 chloride in a patient with Pneumocystis carinii pneumonia and autoimmune hepatitis is described. METHOD In-111 chloride bone marrow scintigraphy was performed to evaluate the bone marrow activity associated with pancytopenia in a 56-year-old woman with autoimmune hepatitis. RESULTS An In-111 chloride bone marrow scan showed increased pulmonary uptake predominantly in both upper lung fields. P. carinii pneumonia was seen to be developing as an immunocompromised complication after treatment for autoimmune hepatitis. CONCLUSION When In-111 chloride bone marrow scintigraphy shows increased uptake in the lungs of immunocompromised patients, a combined opportunistic inflammatory disease such as P. carinii pneumonia should be considered in the diagnosis.

Evaluation of hepatic transport function by hepatobiliary scintigraphy

The transport kinetics of [99mTc]‐pyridoxyl‐5‐methyltryptophan were studied by three‐compartment model analysis for hepatobiliary scintigraphy in 45 patients with chronic viral liver diseases. Three‐compartment model analysis was studied using the time‐activity curves of the regions of the heart, liver, and biliary tract and intestine (excretory compartment). The k12 (hepatic uptake rate constant), k21 (hepatic efflux rate constant), and ke1 (hepatic excretion rate constant) were calculated by the nonlinear least‐squares method. Among the three parameters obtained by model analysis, k12 values more prominently differed among diseases and correlated well with blood tests such as total bilirubin, total bile acids, or 15 min retention of ICG. In conclusion, three‐compartment model analysis of the hepatic handling of [99mTc]‐pyridoxyl‐5‐methyltryptophan is useful in evaluating hepatic transport function. k12 is the most sensitive parameter for this.