The significance of functioning gallbladder visualization on hepatobiliary scintigraphy in infants with persistent jaundice.
The purpose of this study was to determine whether gallbladder visualization can help exclude biliary atresia in hepatobiliary scintigraphic studies of infants with persistent jaundice.


METHODS
One hundred fifty-two infants with persistent jaundice (49 patients with a final diagnosis of biliary atresia and 103 with biliary patency) were studied using both hepatobiliary scintigraphy and abdominal sonography. Food was withheld for 4 h before the examination, and the infants were fed nothing but glucose until 6 h after the initial injection of (99m)Tc-disofenin or until the gallbladder was seen. If the gallbladder was seen, the infants were fed milk, and imaging was continued to observe gallbladder contractility.


RESULTS
In none of the 49 patients with biliary atresia could the gallbladder be seen with hepatobiliary scintigraphy, but abdominal sonography revealed 9 normal-sized gallbladders. Of the 103 patients with biliary patency, hepatobiliary scintigraphy detected the gallbladder more frequently (74%, 76/103) than did abdominal sonography (63%, 65/103). All visualized gallbladders contracted after the infants were fed milk. If we include visualization of both the gallbladder and bowel radioactivity as criteria, the specificity of biliary atresia on hepatobiliary scintigraphy increases to 86% (89/103).


CONCLUSIONS
Gallbladders were usually visible on hepatobiliary scintigraphy of fasting patients with biliary patency. A functioning gallbladder, with or without visualization of bowel radioactivity, indicated biliary patency.
Department of Nuclear Medicine, Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan, Republic of China.
C H
CH
Lee
P W
PW
Wang
T T
TT
Lee
M M
MM
Tiao
F C
FC
Huang
J H
JH
Chuang
C S
CS
Shieh
Y F
YF
Cheng
D001656:Biliary Atresia / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000000981:diagnostic imaging* / Q000209:etiology; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D019785:Technetium Tc 99m Disofenin; D014463:Ultrasonography
D019275:Radiopharmaceuticals; D019785:Technetium Tc 99m Disofenin