Abstract
Technetium Tc-99m disofenin cholescintigraphy (CS) and ultrasonography (US) are two major clinical methods used in differentiating biliary atresia (BA) from neonatal jaundice. To compare the diagnostic utility of these two modalities, 66 patients with neonatal cholestasis (15 BA, 3 choledochal cyst (CC), 32 neonatal hepatitis, 13 prolonged jaundice, 2 total parenteral nutrition, and 1 sepsis) underwent Tc-99m disofenin CS and US. The diagnostic sensitivity, specificity, and accuracy of CS in differentiating BA from other forms of neonatal jaundice was 100%, 87.5%, and 90.5%, respectively, and for US 86.7%, 77.1%, and 79.4%, respectively. Tc-99m disofenin CS after premedication with phenobarbital and cholestyramine is a convenient and reliable method of differentiating BA from neonatal hepatitis, with a diagnostic accuracy superior to that of US. However, US is the initial imaging procedure of choice in patients presenting with jaundice to rule out anatomic anomalies such as CC.
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Kasai M, Watanabe I, Ohi R (1975) Follow-up studies of long-term survivors after hepatic portoenterostomy for “noncorrectable” biliary atresia. J Pediatr Surg 10: 173–182
Kasai M, Suzuki H, Ohashi E (1978) Technique and results of operative management of biliary atresia. World J Surg 2: 571–580
Ikeda S, Sera Y, Akagi M (1989) Serial ultrasonic examination to differentiate biliary atresia from neonatal hepatitis — special reference to changes in size of the gallbladder. Fur J Pediatr 148: 396–400
Yaffe SJ, Juchau MR (1974) Perinatal pharmacology. Ann Rev Pharmacol 14: 219–238
Fischer E, Varga F, Gregus Z (1978) Bile flow and biliary excretion rate of some organic anions in phenobarbital pretreated rats. Digestion 17: 211–220
Sharp HL, Mirkin BL (1972) Effect of phenobarbital on hyperbilirubinemia, bile acid metabolism, and microsomal enzyme activity in chronic intrahepatic cholestasis of childhood. J Pediatr 81: 116–126
Gallo DG, Bailey KR, Scheffner AL (1965) The interaction between cholestyramine and drugs. Proc Soc Exp Biol Med 120: 60–65
Wang SJ, Yeh SH, Chen KS (1987) The effect of cholestyramine on 99mTc-hepatolite cholescintigraphy in diagnosing biliary atresia — a preliminary report. Chung Hua I Hsueh Tsa Chili 39: 60–63
Mourey MS, Amedee MO (1992) Retinyl palmitate hydrolase activity in human liver. Am J Clin Nutr 55: 729–733
Vajro P, Couturier M, Lemonnier F (1986) Effects of postoperative cholestyramine and phenobarbital administration on bile flow restoration in infants with extrahepatic biliary atresia. J Pediatr Surg 21: 362–365
Majd M, Reba RC, Altman RP (1981) Effect of phenobarbital on 99mTc-IDA scintigraphy in the evaluation of neonatal jaundice. Semin Nucl Med 11: 194–204
Massoud M, Richard CR (1981) Hepatobiliary scintigraphy with 99mTc-PIPIDA in the evaluation of neonatal jaundice. Pediatrics 67: 140–145
Abramson SJ, Treves S, Teele RL (1982) The infant with possible biliary atresia: evaluation by ultrasound and nuclear medicine. Pediatr Radiol 12: 1–5
Brun P, Gauthier F, Boucher D (1985) Ultrasound findings in biliary atresia in children. A prospective study with surgical correlation in 86 cases. Ann Radiol Paris 28: 259–263
Gates G, Sinatra F, Thomas D (1980) Cholestatic syndromes in infancy and childhood. AJR 134: 1141–1148
McGahan JP, Phillips HE, Stadalnik RC (1983) Ultrasound and radionuclide biliary scanning in acute pediatric abdominal pain. J Clin Ultrasound 11: 251–258
Morgan CL, Trought WS, Oddson TA (1980) Ultrasonography in the diagnosis of type I choledochal cyst. South Med J 73: 1389–1391
Filly RA, Carlsen EN (1976) Choledochal cyst: report of a case with specific ultrasonographic findings. J Clin Ultrasound 4: 7–10
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Lin, W.Y., Lin, C.C., Changlai, S.P. et al. Comparison technetium of Tc-99m disofenin cholescintigraphy with ultrasonography in the differentiation of biliary atresia from other forms of neonatal jaundice. Pediatr Surg Int 12, 30–33 (1997). https://doi.org/10.1007/BF01194798
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DOI: https://doi.org/10.1007/BF01194798