Hepatic Distribution of Blood Flow from the Superior or Inferior Mesenteric Vein Mapped by Portal Scintigraphy with Iodine-123-Iodoamphetamine

We previously reported the clinical meaning of measurements of the relative contributions of the superior and inferior mesenteric veins with [ 123 I]iodoamphetamine after oral (in an enteric capsule) and rectal administration. The same method was used to map blood flow in the liver from both of these veins in 82 subjects, 31 with chronic hepatitis and 51 with cirrhosis. Methods : Three hours after administration of a capsule containing 22.8 MBq of [ 123 I]iodoamphetamine, data showing hepatic blood flow from the superior mesenteric vein were collected for 10 min. Next, 111 MBq of [ 123 I]iodoamphetamine was administered rectally and data showing hepatic blood flow from the inferior mesenteric vein were collected for 30 min. Shunt indices from the superior and inferior mesenteric veins were calculated from these data. Results : In patients with chronic hepatitis, blood from the superior mesenteric vein flowed into the right lobe or both lobes, but, in some patients with cirrhosis, blood from this vein flowed into the left lobe. In some patients with chronic hepatitis, blood from the inferior mesenteric vein flowed into the left lobe, but, in most patients with cirrhosis, the liver was not visualized during this examination and evaluation was not possible. Of the 53 patients in whom blood flow from both veins could be evaluated, 47 had blood from the two veins mixed to some extent in the liver and 6 had portal streamlining, with blood from the superior mesenteric vein going to the right lobe and blood from the inferior mesenteric vein going to the left lobe. Conclusion : These results suggest that blood flow in the superior and inferior mesenteric veins can be found mixed in the liver in most subjects with liver disease.