^99mTc-Phy Portal Perfusion Index Imaging Helps Predict The Severity Of HBV Cirrhosis. A Preliminary Study

ObjectiveTo perform exploratory research on the application of 99mTc-Phytate(Technetium[99mTc]Phytate,99mTc-Phy)portal perfusion index(PPI)imaging in predicting the complications of hepatitis B cirrhosis and their severity.MethodsSixty-five hepatitis B cirrhosis patients who underwent outpatient and hospitalized treatment between April 2011 and August 2016 at the First Affiliated Hospital of Zhejiang University School of Medicine were analyzed.The patients were stratified according to Child-Pugh(C-P)scores and a five-stage prognostic system,respectively,into a total of three groups for Classes A to C(38 cases in Class A,15 cases in Class B,and 12 cases in Class C)and a total of five groups for Stages 1 to 5(12 cases in Stage 1,10 cases in Stage 2,18 cases in Stage 3,20 cases in Stage 4,and 5 cases in Stage 5).The portal perfusion index(PPI)differences were compared among the three and five groups,respectively,and the correlations between PPI and biochemical indices,such as serum total protein,serum albumin,serum globulin,albumin/globulin,alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,total bilirubin,direct bilirubin,and indirect bilirubin were analyzed.One-way analysis of variance was used to compare the PPIs among various groups,and a non-parametric Spearman test was used to analyze the correlations between PPIs and various biochemical indices.ResultsThe PPIs of the five groups gradually decreased from Stage 1 to Stage 5(73.03±8.49,52.96±16.22,46.24±15.25,29.99± 17.36,and 11.50±6.37,respectively);with the exception ofthe difference between Stages2and 3(P=0.252),the differences between the remaining groups were statistically significant(P<0.05).PPI showed positive correlations with serum total protein,serum albumin,and albumin/globulin results(r?0.292,P<0.05;r?0.559,0.520,respectively,P<0.01)and showed negative correlations with serum globulin,aspartate aminotransferase,alkaline phosphatase,and direct bilirubin results(r=-0.366,P<0.01;r=-0.197,-0.165,and-0.025,respectively,P>0.05).Conclusion99mTc-Phy PPI is promising to be a noninvasive and effective method for predicting the complications of hepatitis B cirrhosis and their severity;a lower PPI value indicates a higher severity of complications for hepatitis B cirrhosis patients.PPI can provide very meaningful reference data for clinical practice.