^99mTc-EHIDA Hepatobiliary Imaging In Persistent Jaundice In Infants

OBJECTIVE Combined with postoperative pathological diagnosis as standard, analysis of 99mTc-EHIDA hepatobiliary imaging applications in persistent jaundice in infants.METHODS Select to 63 patients in Pediatric Surgery of FAHGMU (The First Affiliated Hospital of Guangxi Medical University), with persistent jaundice symptom, using 99mTc-EHIDA Hepatobiliary Scintigraphy test to examination, then all patients were treated by operation. The clinical and pathology diagnosis, the result is divided into two groups:Biliary Atresia group and Infantile Hepatitis Hyndrome group. Evaluated 99mTc-EHIDA Hepatobiliary Scintigraphy performance test to cause persistent jaundice infants.RESULTS1. Follow to 63 cases with 99mTc-EHIDA Hepatobiliary Scintigraphy test,there were 44 cases (44/63) were negative (intestinal did not display) and 19 cases (19/63) were positive (intestinal has display were different degrees).By Surgery and Pathology treatment, this 63 cases showed 45cases were BA(Biliary Atresia),18 cases were IHS(Infantile Hepatitis Syndrome). In 45 BA cases have 34 cases were negative,11 cases were positive with 99mTc-EHIDA Hepatobiliary Scintigraphy. In 18 cases IHS have 10 cases were negative,8 cases were positive with 99mTc-EHIDA Hepatobiliary Scintigraphy. The Tc-EHIDA imaging diagnostic with BA has sensitivity was 75.6% (34/45), specificity was 44.4% (8/18), the false positive rate was 22.7% (10/44); with IHS has sensitivity of 44.4% (8/18) and the specificity was 75.6% (34/45).99mTc-EHIDA diagnostic imaging has general accuracy was 66.7% (42/63).2. Biochemical Results of 63 cases children undergoing treatment have TBiL, DBiL, ALT, AST increased compare with normal children; between the BA group and IHS group that TBiL, DBiL, ALT, AST, the difference wasn’t statistically significant (P=0.827, P=0.323, P=0.554, P=0.763),3.63 cases in children have been pathologically confirmed 10 cases have cirrhosis, all were in BA group. This study was divided into two groups according to age at surgery:children little 60 days,18 cases that two cases were liver cirrhosis (2/18); children more 60 days have 27 cases that 8 cases were liver cirrhosis (8/27), the difference wasn’t statistically significant (X2= 2.143, P =0.272). In liver cirrhosis cases group, the average age were 87.1 days, the average age in normal cases group were 80.2 days, the difference wasn’t statistically significant (t=0.505, P=0.616).4. BA usually were divided to three type, BA-type I was complete biliary atresia, there were 3 cases (6.7%); BA-type Ⅱ was proximal biliary atresia and biliary patency distal 2 cases (4.4%); BA-type Ⅲ was proximal bile duct patency, distal bile duct fibrosis for 40 cases (88.9%); the difference was statistically significant (X2=62.533, P<0.001).CONCLUSION1.99mTc-EHIDA hepatobiliary scintigraphy diagnostic sensitivity of BA significantly higher diagnostic sensitivity IHS.2.99mTc-EHIDA hepatobiliary scintigraphy for diagnosis of biliary atresia and infantile hepatitis syndrome has important clinical value.3. Cholestatic cirrhosis occurs mainly in biliary atresia, and with time increased incidence own.