Usefulness of ICG Clearance Meter in Assessing the Pathogenesis of the Liver Dysfunction-Report of a Hepatic Carcinoma Patient

A-63-year old man underwent abdominal ultra sonography for detection of a liver tumor in S6. The 15-minute retention rates of ICG (R15) showed a high value of 20%as compared with the patient's protein synthesis and coagulation functions. The ICG clearance curve showed an unusual high secondary peak as liver cirrhosis, and indicated the presence of a portocaval shunt. Abdominal angiography revealed a hypervascular tumor stain at S6 with daughter lesions, and hepatic artery-portal vein shunt (A-P shunt) induced portal hypertension. Also, the distal site of right and left branch of portal vein were not visualized and major collateral circulation from splenic vein to inferior vena cava were demonstrated. After transcatheter arterial embolization (TAE) to the posterior branch of hepatic artery, the high 2nd peak of ICG clearance curve disappeared, and R15 findings improve to 12%. In conclusion, accurate liver function diagnosis was possible by assessing the pathogenesis with the ICG clearance curve.