A. Relationship between histological findings of the liver and BSP or ICG test.
In forty-nine patients with hepatocellular disorders were performed histological examination of liver through needle biospy, Indocyanine Green (ICG) and Bromsulphalein (BSP) excretion test. The patients with intra- and extra-hepatic cholestasis were excluded from this study.
The plasma concentrations of ICG and BSP were determined for at least sixty minutes after an injection. Plasma disappearance rate (K) and transfer rate constants (a, b, h) were calculated from the plasma disappearance curves by means of two compartment analysis.
The results were summarized as follows:
1. Decrease of K_ICG had a significant correlation with progress of acini-reconstruction, and a_ICG decreased in proportion to extent of fibrosis in Glisson's sheaths.
2. Decrease of K_BSP had a significant correlation with progress of inflammatory cell infiltration in Glisson's sheaths, of destruction of limiting plates and of reconstruction of acini. Changes of a_BSP had the similar correlation as K_BSP.
B. Relationship and discrepancy between ICG and BSP test.
Although apparent discrepancy was observed between ICG and BSP test in 7 cases among forty-nine patients with hepatocellular disorders, four patients were excluded because of the significant difference of theoretical value by the ICG and BSP space. Therefore, forty-five patients were comprised the subjects of this study.
The correlations between BSP and ICG test were examined on the following items: plasma disappearance rate of BSP (K_BSP)-plasma disappearance rate of ICG (K_ICG), K_BSP-retention rate of percentage at 15 minutes of ICG (R_15ICG), retention rate of percentage at 45 minutes of BSP (R_45BSP)-K_ICG, and R_45BSP-R_15ICG.
Values of K_BSP-K_ICG and K_BSP-R_15ICG had a significant relationship (p<0.01). From the statistical examination of rejection elipse on these two items two cases of active type of chronic hepatitis and one of active form of liver cirrhosis were recognized as the cases with discrepancy between BSP and ICG excretion. In these three cases K_BSP was lower than K_ICG, a_ICG was higher than a_BSP and b_BSP was higher than b_ICG.
From these results it was suggested that the hepatocellular inflammatory change was one of causes of discrepancy between BSP and ICG.