Value of hepatobiliary scintigraphy combined with total bile acid and γ-glutamyltransferase detection in etiological diagnosis of the persistent jaundice in infants
10.3760/cma.j.issn.2095-428X.2014.19.006
- VernacularTitle:放射性核素肝胆显像联合总胆汁酸、谷氨酰转肽酶检测对婴儿持续性黄疸的诊断价值
- Author:
Yongshuai QI
;
Li DU
;
Xiaohua CHI
;
Feng LIU
;
Zhifang DENG
;
Guiping LI
- Publication Type:Journal Article
- Keywords:
Hepatobiliary scintigraphy;
Infantile hepatitis syndrome;
Extrahepatic biliary atresia;
Differential diagnosis
- From:
Chinese Journal of Applied Clinical Pediatrics
2014;29(19):1459-1462
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of hepatobiliary scintigraphy combined with total bile acid (TBA) and γ-glutamyhransferase(γ-GT) detection in the differential diagnosis of persistent jaundice induced by infantile hepatitis syndrome(IHS) and congenital extrahepatic biliary atresia(EHBA).Methods A retrospective analysis of 60 infants with persistent jaundice undertaking 99Tcm-diethylacetanilide iminodiacetic acid (EHIDA) hepatobiliary scintigraphy was done in Nanfang Hospital by single photon emission computed tomography(SPECT).Meanwhile,these infants' sera were collected and separately detected by AU5431 automatic biochemical assay;the sensitivity,specificity and accuracy of hepatobiliary scintigraphy with TBA and γ-GT were evaluated.Results The sensitivity to 99Tcm-EHIDA hepatobiliary scintigraphy in the diagnosis of IHS and EHBA were 100.00％ (17/17 cases) and 67.57％ (25/37 cases),the specificity was 67.57％ (25/37 cases) and 100.00％ (17/17 cases),and the accuracy was 77.78％ (42/54cases) and 77.78％ (42/54 cases),respectively.The levels of TBA and γ-GT were higher in infants with EHBA than those with IHS(U =209.0,19.5,all P ＜0.05),and ROC curve analysis indicated that TBA in the IHS group and γ-GT in EHBA group had some diagnostic value[area under curve (AUC) =0.736,0.968,respectively].99Tcm-EHIDA hepatobiliary scintigraphy combined with TBA and γ-GT analysis suggested when intestinal non-radioactive imaging was shown,TBA was 98.5 μmol/L and γ-GT was 298 U/L,the sensitivity,specificity and accuracy of diagnosis of EHBA were 100.00.00％ (17/17 cases),100.00％ (37/37 cases) and 100.00％ (54/54 cases) in a serial test.Conclusions Hepatobiliary scintigraphy combined with TBA and γ-GT examination can effectively identify EHBA and IHS earlier,noninvasively and safely,which have important role in further treatment in infants with persistent jaundice.
