放射性核素肝胆显像在新生儿阻塞性黄疸诊断中的应用进展

Clinical Application Progress of Radionuclide Hepatobiliary Scintigraphy in the Diagnosis of Neonatal Obstructive Jaundice

新生儿阻塞性黄疸是儿科临床常见的一类疾病,病因复杂,其鉴别诊断仍然是一个难点。放射性核素肝胆显像对新生儿阻塞性黄疸尤其是先天性肝外胆管闭锁和新生儿肝炎综合征的诊断和鉴别诊断具有较大的临床应用优势。在放射性核素肝胆显像剂中以标记放射性同位素锝(99Tcm)发展最快,具有适宜的半衰期(6.02 h)和(140 keV)低能γ射线。目前,多数99Tcm标记的肝胆显像剂受高胆红素的影响,诊断的准确性普遍不令人满意。探讨具有肝摄取率高,排泄时间短,胆红素影响小的99Tcm标记的肝胆显像剂,将是一个新的研究课题。

Neonatal obstructive jaundice is a clinically common pediatric disease with complex etiology, and it is still a difficult problem in differential diagnosis. However radionuclide hepatobiliary imaging has great advantages in the diagnosis and differential diagnosis of neonatal obstructive jaundice, especial!y congenital biliary atresia and infant hepatitis syndrome. Marked radioisotope technetium （99 Tcm） has developed the fastest among the radionuclide hepatobiliary imaging agents, since it has a suitable half-life （ 6.02 h） and low-energy（ 140 keV） γ rays. At present,the majority of 99Tern labeled hepatobiliary imaging agents are affected by hyperbilirubinemia, and the accuracy of the imaging diagnosis is not satisfactory. 99Tcmlabeled hepatobiliary imaging agent with high liver uptake tale, fast biliary excretion and little effect from bilirubin, will become a new topic in the research field.