Tc-99m-diethyl-IDA imaging: clinical evaluation in jaundiced patients.
Hepatobiliary imaging with Tc-99m-N,alpha-(2,6-diethylacetanilide)-iminodiacetic acid (Tc-diethyl-IDA) was performed in 91 jaundiced patients with documented hepatobiliary damage and serum total bilirubin up to 35 mg/dl. There were 56 patients with obstructive jaundice and 35 with hepatocellular disease. Correct discrimination between hepatocellular and obstructive jaundice was possible with an overall accuracy of 90%. Agreement with the final clinical diagnosis was obtained in 97% of patients with hepatocellular disease, and in 86% of patients with obstructive jaundice. The reliability of the test was inversely related to the serum bilirubin concentration. The incidence of true-positive scans dropped from 93% for bilirubin levels below 10 mg/dl to 83% for bilirubin between 10 and 20 mg/dl. Above 20 mg/dl, the demonstration of a mechanical obstruction was possible in only one out of the four patients with obstructive jaundice. The high predictive values of the test illustrate that Tc-diethyl-IDA imaging constitutes a reliable method to demonstrate an obstructive cause for the jaundice as long as the bilirubin level remains below 20 mg/dl.
D001663:Bilirubin / Q000097:blood; D002779:Cholestasis / Q000097:blood / Q000000981:diagnostic imaging* / Q000209:etiology; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology; D005069:Evaluation Studies as Topic; D005189:False Positive Reactions; D006801:Humans; D007098:Imino Acids; D011877:Radionuclide Imaging; D013667:Technetium; D019784:Technetium Tc 99m Diethyl-iminodiacetic Acid
D007098:Imino Acids; D019784:Technetium Tc 99m Diethyl-iminodiacetic Acid; D013667:Technetium; D001663:Bilirubin