董一女，毛一雷

(中国医学科学院 中国协和医科大学 北京协和医院 肝脏外科中心，北京100730)

摘要：肝脏显像分析肝功能是除血液检测结果外的另一检查肝功能手段，由于能结合影像学技术来分析肝功能，故对肝病围手术期有重大意 义，也是指导治疗和评价预后的有效依据。目前肝脏显像技术呈现多元化发展，去唾液酸糖蛋白受体（asialoglycoprotein receptor，ASGPR）显像剂的发现与问世，使越来越多的目光聚焦于核医学显像。最新的ASGPR显像剂99mTc- GSA（technetium galactosyl human serum albumin diethylenetriamine pentaacetic acid injection）具有良好的趋肝性和受体介导结合特性，将其用于临床单光子发射型计算机断层（single photon emission computed tomography，SPECT）三维图像，能够定量地评价肝脏功能，目前在国内尚无临床使用报道。在未来，还可能将ASGPR或其它新型显像剂和 PET-CT技术相结合，进行显像，将在功能上和解剖学结构上对病变可能切除区域及切除区域以外肝组织作出更为准确判断。

关键词：肝脏显像；ASGPR显像剂；NGA；GSA；肝功能

The status in quo and prospect of liver imaging to check the liver function

DONG Yi-nv ，MAO Yi-lei 

(Liver Surgery Center, CAMS & PUMC, Beijing 100730, China)

Abstract: Liver imaging is another method aside from chemo analysis to check the liver function. It exerts significant roles in instructing management and predicting prognosis of liver diseases, especially during the perioperative period. The current liver imaging technology develops in diverse directions, in which the advent of the developer of asialoglycoprotein receptor (ASGPR) draws increasing attentions to nuclear medicine image. The lateset ASGPR, 99mTc-GSA, the technetium galactosyl human serum albumin diethylenetriamine pentaacetic acid injection, is highly hepatotropic and has a favorable receptor-mediated combination property. When applied with the single photon emission computed tomography(SPECT), it can help evaluating the liver function quantitatively. There hasn't been any domestic report of clinical application yet. In the future, it is possible to combine ASGPR or other new developers with the technology of PET-CT to make a precise evaluation of the would-be excised lesion and the left liver tissue functionally and anatomically.

Key words: liver imaging；imaging agent of ASGPR；NGA；GSA；liver function

慢性肝炎、肝硬化以及肝癌是严重危害健康的一系列疾病，在我国的发病率尤其高，对其功能状态进行准确的评价，不仅对肝脏围手术期具重大意义，也是指 导治疗和评价预后的有效依据。从Child－Pugh分级到血液检测肝脏清除或负荷试验等，所评价的结果往往反映了术前全肝的功能[1]，随着多种影像学 手段的问世，肝脏显像在肝功能研究方面取得飞速进展，使三维立体随意测试某一区段的肝功能成为可能。