胆汁淤积型肝炎99mTc-EHIDA与99mTc-MIBI肝胆显像对比研究

Contrast study of 99mTc-EHIDA hepatobiliary imaging and 99mTc-MIBI hepatobiliary imaging in cholestatic hepatitis

目的探讨99mTc-MIBI肝胆动态显像是否可用于婴儿肝炎综合征和先天性胆道闭锁的鉴别诊断,为临床诊治提供依据。方法随机抽取34例99mTc-EHIDASPECT肝胆动态延迟显像肠道不显影而最终临床诊断为胆道闭锁的患儿作为观察组,10例同期临床诊断为肝炎综合征的患儿作为对照组,在行99mTc-EHIDA肝胆显像后次日行99mTc-MIBI肝胆显像;对比分析99mTc-EHIDA与99mTc-MIBI肝胆显像在婴儿先天性胆道闭锁及婴儿肝炎综合征的影像特征。结果34例观察组和10例对照组99mTc-MIBI肝胆显像均出现肠道显影,且肠道放射性分布出现时间较早,提示肠道放射性并非来自肝胆排泄而是肠道自身的摄取。结论对于99mTc-EHIDASPECT肝胆显像肠道未出现放射性核素影像的黄疸患儿,99mTc-MIBI肝胆显像对于婴儿肝炎综合征和先天性胆道闭锁的鉴别诊断价值有限。

Objective To investigate whether 99m Tc-MIBI hepatobiliary dynamic imaging can be used for differential diagnosis of infantile hepatitis syndrome and congenital biliary atresia,so as to provide basis for clinical diagnosis and treatment.Methods Thirty-four patients who underwent dynamic delayed 99m Tc-EHIDA SPECT without intestinal imaging and were eventually diagnosed with biliary atresia were randomly selected as the observation group,ten patients who were clinically diagnosed with hepatitis syndrome at the same time were selected as the control group.All the patients underwent 99m Tc-MIBI hepatobiliary imaging the next day after undergoing 99m Tc-EHIDA hepatobiliary imaging.The imaging characteristics of 99m Tc-EHIDA hepatobiliary imaging and 99m Tc-MIBI hepatobiliary imaging in infants with congenital biliary atresia and infantile hepatitis syndrome were compared and analyzed.Results All the 34 cases in the observation group and 10 cases in the control group had intestinal images displayed on 99m Tc-MIBI hepatobiliary imaging,and the intestinal radioactivity distribution appeared earlier,and it was suggested that the intestinal radioactivity did not come from the hepatobiliary excretion but from the intestinal absorption by itself.Conclusion For the patients with jaundice who do not have intestinal radioactivity imaging on 99m Tc-EHIDA SPECT hepatobiliary imaging,the value of 99m Tc-MIBI dynamic hepatobiliary imaging in the differential diagnosis of infantile hepatitis syndrome and congenital biliary atresia is limited.