Diagnosis of cirrhosis and hepatitis by quantitative hepatic and other reticuloendothelial clearance rates

Although methods for measuring colloid clearance rates have been described, they are not commonly used. Rather, most clinicians rely on the relative radiocolloid accumulation in the liver and spleen as estimated by visual inspection of liver scans. This method lacks objectivity, however, and only indirectly reflects the rate of radiocolloid clearance. The authors have developed a noninvasive kinetic technique for measuring radiocolloid clearance by the liver, spleen, and other reticuloendothelial tissues. The clearance rate constants obtained by this technique appear to differentiate among cirrhosis, fatty metamorphosis, hepatitis, and normal function. In normal subjects, the mean clearance rate constants for the liver, spleen, and extrahepatosplenic reticuloendothelial system were 16.0, 1.4, and 3.4 ml/min per 100 ml of plasma, respectively. The mean hepatic clearance rate constant was normal in hepatitis (16.8 ml/min per 100 ml), reduced in cirrhosis (5.7), and slightly reduced in fatty metamorphosis (10.4). Both the hepatic to splenic and the hepatic to extrahepatosplenic ratios of clearance rate constants were reduced in cirrhosis and slightly reduced in fatty metamorphosis and hepatitis. Interestingly, the splenic clearance rate constants were normal in these three diseases.