[Angiomatosis of the liver]. / Naczyniakowatosc watroby.

Cavernous haemangioma of the liver is the most frequently observed benign hepatic tumour. Polyangiomatosis is a great rarity, and in view of the similarity to metastatic tumours, it is a serious diagnostic problem. In the paper three cases are described of polyangiomatosis of the liver diagnosed on the basis of abdominal ultrasonography. Final diagnosis was made analysing USG, CT, scintigraphy with labelled erythrocytes, and laparoscopy. In all described cases, despite significant enlargement of the liver containing multiple hemangiomas, no features indicating liver damage were found in the laboratory investigations. This seems to be an important diagnostic indicator in the diagnosis of this disease.

[Isotope methods in diagnosis of portal vein occlusion]. / Metody izotopowe w diagnostyce niedroznosci zyly wrotnej.

The dynamic intravenous hepato-scintigraphy with pertechnetate Tc-99m enables a quantitative evaluation of portal and arterial blood flow in the liver. A case is presented of thrombotic occlusion of the portal vein with rapidly growing oesophageal varices in which hepato-scintigraphy showed the absence of portal blood flow in the liver, being the decisive diagnostic method. Using the dynamic transrectal porto-scintigraphy an evaluation was done of the degree of collateral circulation development in the area of the inferior mesenteric vein, obtaining indirect information about localization and duration of portal vein occlusion.

[Static and dynamic scintigraphy of the liver using labeled erythrocytes in the diagnosis of hepatic hemangioma]. / Statyczna i dynamiczna scyntygrafia watroby znakowanymi krwinkami czerwonymi w diagnostyce naczyniaków watroby.

In order to find hemodynamic differences between hemangioma (n = 10) and other tumours of the liver (n = 15) dynamic angioscintigraphy and late vascular scintigraphy of the liver were performed. Late vascular scintigraphy has revealed focal cumulation of the labelled erythrocytes in 7 hemangiomas of the diameter of 35 mm, 3 hemangiomas below this size have not been diagnosed with this technique. Beside hemangiomas, a focus of erythrocytes cumulation was found also in the hepatocellular adenoma. Arterial blood supply to hemangioma was significantly higher, than that in the malignant tumours of the liver (54.6% vs 31.7%). Other parameters of the early phase of angioscintigraphy have no diagnostic value in the differentiating the hepatic tumours. Vascular scintigraphy of the liver proved to be a valuable technique in the diagnosis of large hemangiomas only.

Clinical utility of quantitative assessment of liver haemodynamics in cirrhosis provided by dynamic hepatoscintigraphy.

Interrelationships between quantitative assessment of portal (%Qp) and arterial (%Qa) components of hepatic blood supply obtained by dynamic hepatoscintigraphy, and clinical variables characterizing the severity of liver cirrhosis and portal hypertension were studied in 25 cirrhotic patients. The variables, clinical state, size of oesophageal varices, ascites accumulation, sonographic stigmata of portal hypertension, liver mass and elimination rate of lidocaine and antipyrine were studied. The %Qa rose in proportion to the severity of liver injury estimated from the Child-Turcotte and McCormick grading scores. The mean %Qa for patients with Child A cirrhosis was significantly higher than that for 8 healthy subjects (34.8 +/- 7.9% vs 18.1 +/- 4.0; P < 0.01). The %Qp values showed relationship with the size of esophageal varices, provided discriminatory data with respect to the ascitic fluid accumulation and the development of intraabdominal collateral circulation. The liver mass had no impact on hepatic dual blood supply pattern, but was linked with the rate of antipyrine clearance. Neither antipyrine clearance nor lidocaine elimination rate corresponded to alterations of hepatic dual blood supply. The %Qp showed a negative correlation with the initial half-life of lidocaine, which was referred to lowered hepatic uptake of the drug. It is concluded that the quantitative assessment of %Qp and %Qa reflect the advancement of portal hypertension better than liver function failure does.

[Giant hepatic hemangioma--diagnostic value of radioisotope investigations]. / Olbrzymi naczyniak watroby--wartosc diagnostyczna badan izotopowych.

In an example of a 60-year-old female patients with a giant hepatic haemangioma the authors discuss the diagnostic possibilities of radioisotope angiography in the detection of this vascular pathology. In confrontation with ultrasonographic examinations, computerized tomography, laparoscopy and even coeliac angiography only later hepatic scintigraphy using labelled erythrocytes was of decisive diagnostic importance.

[Usefulness of the evaluation of blood supply and mass of the liver for predicting the rate of pharmacokinetics of lidocaine, propranolol and phenazone]. / Przydatnosc oceny ukrwienia i masy watroby dla przewidywania farmakokinetyki lidokainy, propranololu i fenazonu.

A group of patients with hepatocirrhosis were studied for the speed of liver elimination of lidocaine iv (n = 11), propranolol per os (n = 8) and phenazone per os (n = 19); they were also studied for blood supply in liver by means of sequential hepatoscintigraphy. Ultrasonography was used to evaluate the portal system and collaterals of the collateral circulation, endoscopy was used to evaluate the size of oesophageal varices, lateral projection of scintigraphic picture made it possible to calculate the liver mass. The half-life of propranolol and lidocaine in the initial phase of elimination correlated with the degree of portal-arterial disorders in liver blood supply. Propranolol bioavailability correlated with the diameter of the portal vein and was dependent on the size of oesophageal varices and the presence of cavernous transformation of the portal vein. No correlation was found between hepatic clearance of phenazone and vascular pathology of cirrhotic liver, but positive correlation was found between clearance and liver mass. Morphological and functional examinations of the vascular system of the cirrhotic liver were of greater predicative value for the evaluation of the pharmacokinetics of drugs than clinical progression of hepatocirrhosis in the Child-Turcott classification.

[Angiographic and scintigraphic studies in cerebral arteriovenous malformations]. / Badania angiograficzne i scyntygraficzne w malformacjach naczyn mózgowych.

In 9 patients with cerebral vascular malformations diagnosed by contrast radiography, brain scintigraphy was performed also. The radioisotope investigation confirmed the presence of these lesions in only 4 cases (44%). The relatively low per cent of positive scintigrams was due mainly to the small size of some lesions. Brain scintigraphy can be used only for the diagnosis of vascular malformations in cases in which contrast radiography cannot be done.