Diagnosis of biliary atresia with radionuclide hepatobiliary imaging.

Gerhold, J P; Klingensmith, William C.; Kuni, Christopher C.; Lilly, John R.; Silverman, Arnold; Fritzberg, Alan R.; Nixt, T L

doi:10.1148/radiology.146.2.6681570

Cited by 67 publications

(22 citation statements)

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“…Both sexes are affected equally. No single test has proven 100% reliable in diagnosing BA (6,7). 99mTc trimethyl bromo iminodiacetic acids is considered best for Hepato-biliary Scintigraphy because of its 98% hepatic extraction and urinary excretion of 1.5% (8).…”

Section: Discussionmentioning

confidence: 99%

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Role of Hepatobiliary Scintigraphy and Ultrasonography in the Diagnosis of Biliary Atresia in Infant with Neonatal Jaundice – Experiences in NINMAS

Sultana¹,

Jabin

Bashir

et al. 2017

Bangladesh J. Nuclear Med.

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Objective: The purpose of this study was to determine whether gall bladder visualization can help to exclude the biliary atresia in hepatobiliary scintigraphic studies of infants with persistent jaundice.Methods: This is a retrospective study carried out at the National Institute of Nuclear Medicine and Allied Sciences (NINMAS). Study subjects include infants with neo-natal jaundice who underwent Hepatobiliary scintigraphies for suspected biliary atresia and study period was 2 years. Food was withheld for 4 hours before the examination. Anterior images of liver and gall bladder were taken after i/v administration of 2 -3 mci 99m Tc labeled Brida (HIDA) at 5 min interval for 2 hours then at 4 hours and 24 hours. Non-visualization of bowel activity in HIDA scan in 24hours delayed images was considered as cases of diagnosis of biliary atresia.Results: Thirty-six patients were included in this retrospective study. Patent biliary channels was seen by scintigraphies in 17(47%) patients and biliary atresia was seen in 19(52%) patients. By abdominal US nonvisualization of gall bladder were found in 25(69%) cases and gall bladder visualized in 11(30%) cases. Eight (22%) of 36 patients had biopsy confirmed biliary atresia; all of these had positive scintigraphies and (60%) had positive sonographic findings. Among the 5 false-positive scintigraphies caused by hepatic dysfunction and 2 had normal sonography. Thirty-six patients had periscintigraphic sonography. There were 25/36 (61%) abnormal studies, which included cases with small gallbladder (n = 8) and non-visualized gallbladder (n = 17), but not periportal fibrosis. Conclusion:Gall bladder was usually visible on Hepatobiliary scintigraphy of fasting patients with biliary patency.Both hepatobiliary scintigraphy and sonography are currently the standard imaging investigations for suspected biliary atresia. The complementary role, in which scintigraphy and sonography are important, and recommend follow-up imaging reassessment before making definitive surgical decisions. This will serve to decrease the frequency of false-positive imaging diagnoses of biliary atresia, and hence, avoid unnecessary surgeries.

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Section: Discussionmentioning

confidence: 99%

“…Gall bladder is seen as early as ten minutes and Bowel activity is by 30-40 minutes. The presence of tracer within the small bowel excludes BA (6). Most reviews report sensitivity of hepato-biliary scintigraphy for the diagnosis of BA between 97-100% and the specificity from 33-91% (3,6).…”

Section: Discussionmentioning

confidence: 99%

Role of Hepatobiliary Scintigraphy and Ultrasonography in the Diagnosis of Biliary Atresia in Infant with Neonatal Jaundice – Experiences in NINMAS

Sultana¹,

Jabin

Bashir

et al. 2017

Bangladesh J. Nuclear Med.

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show abstract

“…The presence of tracer within the small bowel excludes BA [12]. Most reviews report sensitivity of hepato-biliary scintigraphy for the diagnosis of BA between 97-100% and the specificity from 33-91% [3,6]. The present study being retrospective is not structured to yield comparable data.…”

Section: Discussionmentioning

confidence: 87%

“…All scans were reviewed and considered positive for Biliary Atresia ( Fig. 1) if the scans showed good liver uptake with no intestinal activity till 24 hr [6] or reduced background activity. These patients were then subjected to laparotomy and operative cholangiography and the findings correlated with scintigraphy.…”

Section: Methodsmentioning

confidence: 99%

Hepato-biliary Scintigraphy in diagnosis of Biliary Atresia

Anand¹,

Handa²,

Singh³

et al. 2006

Medical Journal Armed Forces India

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Background: Biliary Atresia and Neonatal Hepatitis are the two major causes of Persistent Neonatal Jaundice. Differentiation is done by biochemical and radiological tests. Radiological investigations use intra-or extra-hepatic biliary dilation for diagnosing biliary atresia but this is not always reliable. Methods: 14 neonates with persistent conjugated hyperbilirubinemia who had undergone hepato-biliary scintigraphy were retrospectively evaluated and those having Extrahepatic Biliary Atresia were analyzed with reference to operative findings. Results: 11 out of 14 had Extrahepatic Biliary Atresia during operation whereas 3 proved to be false positive. Conclusion: Mebrofenin hepato -biliary scintigraphy is a simple, safe, accurate and cost effective investigation for diagnosis of biliary atresia.

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“…Tc-99m IDA scan can rule out biliary atresia in an infant if patent biliary tree is shown with passage of radiotracer into bowel. The literature reports 91% accuracy, 97% sensitivity, and 82% specificity for hepatobiliary imaging in diagnosis of biliary atresia 4 .…”

Section: Hepatobiliary Scanmentioning

confidence: 99%

Radionuclide applications in paediatric gastroentrology

Sharma¹

2009

Sri Lanka J Child Health

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Diagnosis of biliary atresia with radionuclide hepatobiliary imaging.

Cited by 67 publications

References 0 publications

Role of Hepatobiliary Scintigraphy and Ultrasonography in the Diagnosis of Biliary Atresia in Infant with Neonatal Jaundice – Experiences in NINMAS

Role of Hepatobiliary Scintigraphy and Ultrasonography in the Diagnosis of Biliary Atresia in Infant with Neonatal Jaundice – Experiences in NINMAS

Hepato-biliary Scintigraphy in diagnosis of Biliary Atresia

Radionuclide applications in paediatric gastroentrology

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