放射性核素肝胆显像联合动态十二指肠液检查对婴儿持续性黄疸鉴别诊断的意义

Value of radionuclide hepatobiliary scintigraphy combined continued bilirubin examination of duodenal drainage fluid in differential diagnosis of extrahepatic biliary atresia in infants

目的探讨99mTc-EHIDA肝胆显像联合动态十二指肠液引流检查对婴儿期持续性黄疸鉴别诊断的意义。方法应用SPECT仪对84例15～90d持续性阻塞性黄疸患儿进行肝胆核素显像和动态十二指肠引流液检查。结果核素肝胆显像对先天性胆道闭锁(EHBA)诊断灵敏度为100.0%(29/29),特异度为74.5%(41/55);核素肝胆显像联合动态十二指肠引流对EHBA诊断灵敏度为100.0%(29/29),特异度为100.0%(55/55)。结论99mTc-EHIDA肝胆显像是一种无创、安全、有效的检查方法,与动态十二指肠引流法结合对婴儿持续性黄疸鉴别诊断具有较高的临床价值。

Objective To investigate the diagnostic value of hepatobiliary scintigraphy with 99mTc-EHIDA combined bilirubin examination of duodenal drainage fluid in differentating extrahepatic biliary atresia （EHBA） from other biliary atresia. Methods Hepatobiliary scintigraphy with 99mTc-EHIDA was performed in 84 infants with persistent obstructive jaundice. Bilirubin in duodenal drainage fluid was continuedly examined. Results For diagnosing EHBA, the sensitivity and specificity of hepatobiliary scintigraphy were 100% and 74.5% ; the sensitivity and specificity of hepatobiliary scintigraphy combined with continued bilirubin examination of duodenal drainage fluid were 100% and 100% . Conclusions Hepatobiliary scintigraphy is an noninvasive, safe and valuable examination. Hepatobiliary scintigraphy combined duodenal drainage fluid examination has higher clinical values for differential diagnosis of EHBA from other biliary atresia.