title: Effect of different time phases of radionuclide hepatobiliary scintigraphy on the differential diagnosis of congenital biliary atresia.
abstract: To investigate the value and essentiality of 6- and 24-h delay hepatobiliary scintigraphy in the differential diagnosis of biliary atresia (BA), we retrospectively analyzed 197 infants (121 boys/76 girls; age range, 3-205 days; average age, 63.9 days) admitted to Jiangxi Children's Hospital for persistent jaundice (> 2 weeks), hepatosplenomegaly, and abnormal liver function. After receiving anti-inflammatory treatment and cholagogic pre-treatment for 7-10 days without a clear diagnosis, the children underwent 99mTc-labeled diethylacetanilide-iminodiacetic acid hepatobiliary scintigraphy. BA and infant hepatitis syndrome were diagnosed in 107 and 90 infants, respectively after laparoscopic cholangiography, surgical pathology, or 6-month clinical follow-up. The diagnostic efficiencies of hepatobiliary scintigraphy for BA were evaluated within 50 min and at 6 and 24 h. The areas under the receiver operating characteristic curves within 50 min, at 6 and 24 h were 0.696, 0.829 , and 0.779 , suggesting poor diagnostic value within 50 min, but improvement at 6 and 24 h. The compliance rate of 6- and 24-h imaging for BA diagnosis was 89.34% (176/197; paired chi-square test Kappa value, 0.77; P > 0.05), signifying high consistency. The diagnostic efficiency values of 6-/24-h imaging for BA diagnosis were sensitivity (90.65/89.72%), specificity (74.44/78.89%), accuracy (83.25/84.77%), positive and negative predictive values (80.83/83.48% and 87.01/86.59%), with no significant difference (P > 0.05). To provide optimal treatment in early BA, the- 6-h hepatobiliary scintigraphy had practical value, especially when combined with tomographic or dynamic imaging; 24-h delay imaging was deemed unnecessary because it was not significantly superior.
authors.affiliation: The First Affiliated Hospital of Nanchang University, Nanchang, China yanxingguan2000@aliyun.com.
authors.forename: Y X
authors.initials: YX
authors.lastname: Guan
authors.affiliation: Children's Hospital of Jiangxi Province, Jiangxi, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Children's Hospital of Jiangxi Province, Jiangxi, China.
authors.forename: S H
authors.initials: SH
authors.lastname: Wan
authors.affiliation: Children's Hospital of Jiangxi Province, Jiangxi, China.
authors.forename: J S
authors.initials: JS
authors.lastname: Huang
authors.affiliation: The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: X Q
authors.initials: XQ
authors.lastname: Yang
authors.affiliation: The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: L J
authors.initials: LJ
authors.lastname: Pan
authors.affiliation: The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Q I
authors.initials: QI
authors.lastname: Zhang
authors.affiliation: The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Ou
authors.affiliation: Children's Hospital of Jiangxi Province, Jiangxi, China.
authors.forename: X W
authors.initials: XW
authors.lastname: Peng
authors.affiliation: The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: S Z
authors.initials: SZ
authors.lastname: Liu
authors.affiliation: The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: Q J
authors.initials: QJ
authors.lastname: Chen
authors.affiliation: The First Affiliated Hospital of Nanchang University, Nanchang, China.
authors.forename: J
authors.initials: J
authors.lastname: Lou
mesh_terms: D001652:Bile Ducts / Q000000981:diagnostic imaging*; D001656:Biliary Atresia / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D011877:Radionuclide Imaging; D012189:Retrospective Studies