title: Hepatobiliary scintigraphy for the assessment of biliary stricture after pediatric living donor liver transplantation for hepaticojejunostomy reconstruction: the value of the excretion rate at 60 min.
abstract: HBS is performed to determine the presence of biliary stricture after liver transplantation. We focused on the Ex-60 after an intravenous injection of tracer during HBS. The aim of this study was to review the cutoff values for the diagnosis of biliary stricture by HBS after pediatric LDLT. We analyzed 114 HBS studies using (99m) Tc-PMT in 80 cases after pediatric LDLT. HBS was performed three months after LDLT on a routine basis and/or was performed when ultrasonography and blood test findings indicated biliary stricture. A ROC curve analysis was performed to identify the cutoff value for the correlation between Ex-60 and biliary stricture. The Ex-60 (mean ± s.d.) in the cases diagnosed as having biliary stricture and in normal subjects were 49.1 ± 20.2% vs. 78.0 ± 9.7% (p < 0.01), respectively. As a result of an ROC curve analysis of the Ex-60, the recommended cutoff value to diagnose biliary stricture was set at 69.2% (sensitivity 87.0%, specificity 81.8%). In cases where the Ex-60 by (99m) Tc-PMT HBS is <69.2%, it is recommended that further treatment for biliary stricture should be provided.
authors.affiliation: National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan. fukuda-a@ncchd.go.jp
authors.forename: Akinari
authors.initials: A
authors.lastname: Fukuda
authors.forename: Seisuke
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Takanobu
authors.initials: T
authors.lastname: Shigeta
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kakiuchi
authors.forename: Naoto
authors.initials: N
authors.lastname: Matsuno
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kitamura
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Nosaka
authors.forename: Atsuko
authors.initials: A
authors.lastname: Nakazawa
authors.forename: Mureo
authors.initials: M
authors.lastname: Kasahara
mesh_terms: D000328:Adult; D001652:Bile Ducts / Q000601:surgery; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007583:Jejunum / Q000601:surgery*; D008099:Liver / Q000473:pathology* / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D012372:ROC Curve; D011877:Radionuclide Imaging / Q000379:methods*; D012680:Sensitivity and Specificity; D013997:Time Factors