[Value of cholescintigraphy in the differential diagnosis of direct hyperbilirubinemia in infancy].
Cholescintigraphy using 99mTc-diethyl-, 99mTc-diisopropyl-, 99mTc-iodo-diethyl- and 99mTc-bro-motrimethyl-IDA was performed in 22 newborns and infants with direct hyperbilirubinaemia. Retrospective evaluation of 99mTc-diethyl- and 99mTc-diisopropyl-IDA (n = 18) showed an efficiency of 66% in the differentiation between extrahepatic biliary atresia and neonatal intrahepatic diseases if the hepatocyte-clearance index and transit time were taken into consideration; the sensitivity of detecting extrahepatic biliary atresia was 100%. Cholestyramine treatment (n = 9) did not increase the efficiency of the test. Efficiency was markedly reduced when the serum direct bilirubin level was above 5.5 mg/dl (94 mumol/l). The gall bladder was not visualized in 13 out of 18 examinations. The prospective and retrospective analysis of 99mTc-iodo-diethyl- and 99mTc-bromo-trimethyl-IDA revealed intrahepatic disease in all 6 infants with serum values up to 12.6 mg/dl (216 mumol/l) direct bilirubin; the gall bladder was not visualized in 4 out of 7 examinations.
Universitäts-Kinderklinik, Graz.
J
J
Deutsch
G F
GF
Fueger
I
I
Klos
R
R
Nicoletti
D001656:Biliary Atresia / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006505:Hepatitis / Q000000981:diagnostic imaging*; D006801:Humans; D006932:Hyperbilirubinemia / Q000000981:diagnostic imaging*; D007223:Infant; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000000981:diagnostic imaging; D008297:Male; D011877:Radionuclide Imaging; D013667:Technetium
D013667:Technetium
Wertigkeit der Choleszintigraphie in der Differentialdiagnose der direkten Hyperbilirubinämie des Säuglingsalters.